Mark Timothy Mitchum

Primary specialty

Occupational Health Registered NurseTaxonomy code 163WX0106X

License

1112028 Issued in KY

Practice address

2022 Battery Park Dr
Glendale, KY 42740

Phone

(859) 314-3670

NPI assigned

Dec 17, 2024

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1992512479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 HILLVIEW DR",
            "city": "HORSE CAVE",
            "state": "KY",
            "postal_code": "427498048",
            "telephone_number": "270-540-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 BATTERY PARK DR",
            "city": "GLENDALE",
            "state": "KY",
            "postal_code": "42740",
            "telephone_number": "859-314-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "MARK",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0106X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Occupational Health",
            "state": "KY",
            "license": "1112028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan F. Hill, LLC
• Mary Key, MA, CCC/SLP
• Erica Lee, RN
• Carissa Diane Major, RN
• Amber N Mindock, RN
• Jordan Reid Mudd
• Jayme Lauren Pharis
• Jo Anna Sharp
• Patricia Jane Stith
• Madison Leah Walker

• Occupational Health Registered Nurse in Glendale, KY
• Providers in Glendale, KY by specialty
• Occupational Health Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.