MITCHELL VINCENT MATHIS JR. (NPI# 1588846232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588846232 |
| Entity Type | Individual |
| Full Name | MITCHELL VINCENT MATHIS JR. |
| Credential | M.D. |
| Practice Address |
10630 Little Patuxent Parkway Suite 209 Columbia MD 21044 |
| Practice Telephone | 4107408066 |
| Practice Fax Number | 4107408068 |
| Mailing Telephone | 4107408066 |
| Mailing Fax Number | 4107408068 |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2012-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
D0051608 | MD | Allopathic & Osteopathic Physicians |
| N | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
D0051608 | MD | Behavioral Health & Social Service Providers |
| Street Address |
10630 LITTLE PATUXENT PARKWAY SUITE 209 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417973843 | David Faust Halpern | Dentist | 10630 Little Patuxent Parkway, Ste 104, Columbia, MD 21044 | 2006-07-15 |
| 1831677871 | Columbia Smiles, LLC | Dentist | 10630 Little Patuxent Parkway, Suite 104, Columbia, MD 21044 | 2018-08-01 |
| 1982142493 | Elizabeth Kenney Brandon | Social Worker | 10630 Little Patuxent Parkway, Suite 209, Columbia, MD 21044 | 2017-02-03 |
| 1952640757 | Town Center Chiropractic of Columbia PC | Chiropractor | 10630 Little Patuxent Parkway, Columbia, MD 21044 | 2013-02-14 |
| 1215229182 | Lauren Reed Chapman | Counselor | 10630 Little Patuxent Parkway, Suite 209, Columbia, MD 21044 | 2011-05-10 |
| 1558447748 | Berni J Antelman | Social Worker | 10630 Little Patuxent Parkway, Suite 307, Columbia, MD 21044-3264 | 2006-10-31 |
| 1689757833 | Drs Halpern & Halpern Pa | Dentist | 10630 Little Patuxent Parkway, Suite 104, Columbia, MD 21044 | 2006-10-23 |
| 1982790424 | Melissa A Wilkins | Social Worker | 10630 Little Patuxent Parkway, Ste 214, Columbia, MD 21044-3202 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699331 | Brightview Columbia, LLC | Alzheimer Center (Dementia Center) | 6670 Martin Road, Columbia, MD 21044 | 2020-11-03 |
| 1689291544 | Diana Matthews | Physical Therapist | 6016 Jerrys Drive, Columbia, MD 21044 | 2020-06-26 |
| 1902380926 | Bagiwa Healthcare Services LLC | Nursing Care | 10630 Little Patuxent Park Way, Suite 314i, Colombia, MD 21044 | 2018-09-17 |
| 1295228245 | April Bloom Assisted Living, LLC | Assisted Living Facility | 5037 East Durham Rd, Columbia, MD 21044 | 2018-06-13 |
| 1437659562 | La Shawna A Obame | Counselor | 10451 Twin Rivers Rd Ste 100, Columbia, MD 21044 | 2018-02-15 |
| 1205335262 | Rashida Annette Winestock | Registered Nurse | 10440 Little Patuxent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1215436274 | Terri Lynn Buzby | Registered Nurse | 10440 Little Patuxuent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1134628191 | Sarah Elizabeth Stiltner | Registered Nurse | 10440 Little Patuxent Pkwy Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1326547381 | David Oliver Sloan Jr. | Registered Nurse | 10440 Little Patuxent Parkway Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1467950980 | Jill Sheppard Davenport | Nutritionist | 10801 Hickory Ridge Rd Suite 215, C/o Holistic Child Psychiatry, Columbia, MD 21044 | 2018-01-30 |
| Find all providers in zip 21044 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215292941 | Psychiatric Services of Columbia | Psychiatry & Neurology | 323 Dale St, Columbia, MS 39429-2745 | 2012-07-09 |
| 1497985303 | Rushiraj Chaitanya Laiwala | Psychiatry & Neurology | 2200 Harden St, Columbia, SC 29203 | 2009-07-27 |
| 1407959349 | Lynn Hunter Hackett | Psychiatry & Neurology | 6439 Garners Ferry Road, Wjb Dorn Va Medical Center, Columbia, SC 29209 | 2006-09-06 |
| 1801860515 | Angela Dauby Harper | Psychiatry & Neurology | 1415 Blanding St, Suite 4, Columbia, SC 29201-2922 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235218173 | Anilda R Cabrera | Psychiatry & Neurology | Building 364-a, Avenue D, Perry Point, MD 21902 | 2006-11-02 |
| 1447365804 | Lynn Herkowitz Deutsch | Psychiatry & Neurology | 6205 Executive Blvd, Rockville, MD 20852-3906 | 2006-08-19 |
| 1972513141 | Daniel Michael Beaudry | Psychiatry & Neurology | 8909 Reisterstown Rd, Pikesville, MD 21208-1015 | 2006-08-09 |
| 1083670517 | Allan A Anderson | Psychiatry & Neurology | 405 Dorchester Ave, Cambridge, MD 21613-2421 | 2006-04-24 |
| 1366866808 | David S. Irwin, M.d.,p.a. | Psychiatry & Neurology | 16220 Frederick Rd, Suite 308, Gaithersburg, MD 20877-4039 | 2014-02-04 |
| 1922345115 | Walter Fanburg | Psychiatry & Neurology | 4413 Muncaster Mill Rd, Rockville, MD 20853-1434 | 2013-01-09 |
| 1174878821 | Bon Secours Baltimore Physician Group | Psychiatry & Neurology | 2000 West Baltimore Street, Physician Services, Baltimore, MD 21223 | 2012-07-18 |
| 1639451180 | Renz Jarrett Juaneza | Psychiatry & Neurology | 5601 Loch Raven Blvd., Russell Morgan Building - Suite 406, Baltimore, MD 21239 | 2011-09-11 |
| 1306161542 | William J Polk, Md,pa | Psychiatry & Neurology | 5480 Wisconsin Ave, Suite 421, Chevy Chase, MD 20815-3530 | 2010-03-31 |
| 1205095098 | Tamela Denise Mcclam | Psychiatry & Neurology | 6501 N Charles St, Baltimore, MD 21204-6819 | 2008-06-05 |
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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.