Charlie Mitchell

Key facts

NPI

1992642052

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

Practice address

6784 Highway 411
Benton, TN 37307-4886

Phone

(423) 338-8995

NPI assigned

Apr 29, 2026

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 25, 2026.

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1992642052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6784 HIGHWAY 411",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074886",
            "telephone_number": "423-338-2833",
            "fax_number": "423-338-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6784 HIGHWAY 411",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074886",
            "telephone_number": "423-338-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHARLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, TN

• Victoria L Kinsey, DO
• Aleksander Ivanovich Malakhov, M.D.
• Laurel Martin, NP
• Denise Renee McCluskey, FNP-C
• Priscilla Inez McKnight, RN
• Tonya Morgan, FNP-BC
• Jason Dewayne Nicholson, DDS
• Ocoee Regional Health Corporation
• Ocoee Regional Health Corporation
• Ocoee Regional Health Corporation

All providers in Benton, TN · Physician Assistant in Tennessee