Mary Morgan Mitchell, D.O

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

0102205725 Issued in VA

Practice address

1691 Innovation Dr Ste 2100
Blacksburg, VA 24060-6618

Phone

(540) 232-8405

NPI assigned

May 23, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Academic Primary Care AssociatesGroup PAC ID 3678571866, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110

Merit-based Incentive Payment System (MIPS)

Final score

82.67 of 100Reported as group

Quality

66.8

Promoting interoperability

100

Improvement activities

40

Cost

75.45

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.mitchell.1@26460.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/26460/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Academic Primary Care Associates

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Blacksburg, VA
  • NPI 1053340281

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Lewis Gale Physicians LLC

  • Internal Medicine Physician
  • Salem, VA
  • NPI 1902977705
  Medicare reassignment NPD
• Free Clinic of Pulaski County Inc

  • Primary Care Clinic/Center
  • Pulaski, VA
  • NPI 1225619117
  NPD
• Academic Primary Care Associates

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1003352261
  NPD
• Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Troy, MI
  • NPI 1649952052
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Montgomery Regional Hospital Inc

  • General Acute Care Hospital
  • Blacksburg, VA
  • NPI 1275570376
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1982051660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1088",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243011088",
            "telephone_number": "540-980-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 INNOVATION DR STE 2100",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606618",
            "telephone_number": "540-232-8405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Perry St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483422217",
            "country_code": "US",
            "telephone_number": "248-338-5000",
            "fax_number": "248-338-5567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 4th St NW",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "VA",
            "postal_code": "24301",
            "country_code": "US",
            "telephone_number": "540-980-0922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARY MORGAN",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102205725",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022404",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102205725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Miller, RPH
• Patricia Anna Miller, FNP
• Robert C. Miller, ED.D.
• Mindy R. Jackson, LPC
• Colleen Mitchell, O.D.
• Michael Christopher Mitkos, DO
• Joseph Mock, MD
• Moe'S Reliable Transportation LLC
• Montgomery Hospitalists LLC
• Montgomery Hospitalists LLC

• Sports Medicine (Family Medicine) Physician in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Sports Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.