MICHAEL SHANE MITCHELL (NPI# 1194168807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194168807 |
Entity Type | Individual |
Full Name | MICHAEL SHANE MITCHELL |
Credential | IDC |
Practice Address |
5371 Washington St Camp Lejeune NC 28547-1104 |
Practice Telephone | 8436402075 |
Mailing Telephone | 8436402075 |
Enumeration Date | 2013-04-11 |
Last Update Date | 2013-04-11 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225506652 | Michael Todd Mitchell | Non-emergency Medical Transport (VAN) | 417 Dunvegan Ct, Lafayette, LA 70503-6089 | 2018-11-03 |
1447727227 | Michael Ben Mitchell | Counselor | 6071 E Woodmen Rd Ste 320, Colorado Springs, CO 80923-2612 | 2018-10-30 |
1942686035 | Michael Mitchell | Nurse Practitioner | 4200 Willow Bend Ln, Port Arthur, TX 77642-7231 | 2015-07-31 |
1225440910 | Michael Mitchell | Pediatrics | 14 Medical Park Ste 400, Pediatric Clinic, Columbia, SC 29203 | 2014-05-29 |
1538592902 | Michael Spencer Mitchell | Dentist | 1001 Shadow Ln # Ms 7415, Las Vegas, NV 89106-4124 | 2013-08-20 |
1760699037 | Michael S Mitchell | Social Worker | 109 W 27th St Ste 8a, New York, NY 10001 | 2007-05-17 |
1891852059 | Michael Rickey Mitchell | Counselor | 699 Piedmont Ave Ne Ste B2, Atlanta, GA 30308-1400 | 2007-01-03 |
1538234315 | Michael A. Mitchell | Chiropractor | 5313 Arctic Blvd, Suite 101, Anchorage, AK 99518-1111 | 2006-11-21 |
1871605980 | Michael Scott Mitchell | Chiropractor | 9188 E San Salvador Dr Ste 201, Scottsdale, AZ 85258-5534 | 2006-08-31 |
1104893106 | Michael Calvin Mitchell | Social Worker | 11501 Financial Centre Pkwy, Little Rock, AR 72211-3715 | 2006-03-08 |
Street Address |
5371 WASHINGTON ST |
City | CAMP LEJEUNE |
State | NC |
Zip Code | 28547-1104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558906032 | Abigail Deemer | Physician Assistant | L Street, Bldg Hp-416, Camp Lejeune, NC 28547 | 2019-11-08 |
1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
1215595566 | Kayla L Torrez Chang | General Practice | Mcmh Fc 308, Hm Smith Boulevard, Camp Lejeune, NC 28547 | 2019-06-02 |
1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
1306336995 | Erik Reid King | Physician Assistant | F Street Bldg. Hp206, Camp Lejeune, NC 28547 | 2018-05-18 |
1114434032 | David John Mcdermott | Specialist/Technologist | Bldg. H1 Julian C Smith Rd., Camp Lejuene, NC 28547 | 2017-12-30 |
1235678434 | Nicolle Elizabeth Johnson | Occupational Therapist | 180 Hospital Corps Blvd., Camp Lejeune, NC 28547 | 2017-02-21 |
1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
1043634173 | Garrett Michael Wren | Obstetrics & Gynecology | Naval Medical Center, 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2014-02-10 |
1245662436 | Samuel Maluil | Internal Medicine | Bldg 124 Wallace Creek, Camp Lejeunce, NC 28547 | 2013-07-30 |
Find all providers in zip 28547 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820002 | Levi Para | Military Health Care Provider | 2d Reconnaissance Bn, Psc 20138, Camp Lejeune, NC 28452-0138 | 2020-10-29 |
1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
1881243525 | Alexander Thomas Rodgers | Military Health Care Provider | 2nd Raider Battalion, A66 Boat Basin Rd, Camp Lejeune, NC 28542 | 2019-09-05 |
1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
1578032504 | Brendon Earl Dumas | Military Health Care Provider | Rr612 Everett Creek Road, Camp Lejeune, NC 28542 | 2018-11-20 |
1053896514 | Roy Atallah | Military Health Care Provider | 2nd Marine Raider Battalion, Camp Lejeune, NC 28542 | 2018-10-01 |
1760967509 | Sergeous Evgeney Anikin-dick | Military Health Care Provider | 2d Marine Raider Battalion Psc 20183, Camp Lejeune, NC 28542 | 2018-09-27 |
1295212199 | Ryan Loseke | Military Health Care Provider | 3d Mrb, Camp Lejeune, NC 28460 | 2018-07-24 |
Find all providers in CAMP LEJEUNE |
City | CAMP LEJEUNE |
Zip Code | 28547 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.