Individual provider Active NPI

Michael J. Mitchell, MD

  • Internal Medicine Physician
  • Dartmouth, MA
National Provider Identifier
1992774343
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D76260 Issued in MD
Practice address
531 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone
(508) 996-3991
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D76260 MD Primary

Addresses

Primary practice location

531 Faunce Corner Rd
Dartmouth, MA 02747-1242

Mailing address

531 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

Other practice location 1

531 Faunce Corner Rd
Dartmouth, MA 02747
Phone (508) 996-3991 ext. 2857

Other identifiers 1

IdentifierTypeStateIssuer
110034072AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D76260MDMDInternal Medicine Physician
31263SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Primary Care Inc Internal Medicine Past Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine Past Accepting new patients
Western Maryland Health Care Corporation Past Accepting new patients
Hawthorn Medical Associates, LLC Internal Medicine Past Accepting new patients
Wih Faculty Practice, Inc Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1992774343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 Faunce Corner Rd",
            "address_purpose": "LOCATION",
            "city": "Dartmouth",
            "state": "MA",
            "postal_code": "02747",
            "country_code": "US",
            "telephone_number": "508-996-3991 x2857",
            "fax_number": "508-961-2965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D76260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110034072A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.