JACOB MITCHELL (NPI# 1598250292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598250292 |
| Entity Type | Individual |
| Full Name | JACOB MITCHELL |
| Other Name | JAKE MITCHELL |
| Credential | PA-C |
| Practice Address |
1000 Se Uglow Ave Dallas OR 97338-2645 |
| Mailing Address |
Po Box 13129 Salem OR 97309-1129 |
| Practice Telephone | 5036238376 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2020-03-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA195749 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356800742 | Jacob Anderson Mitchell | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2019-03-15 |
| 1508216813 | Jacob Robert Mitchell | Radiology | 1120 W Michigan St, Gatch Hall Suite Cl 627, Indianapolis, IN 46202-5209 | 2016-06-16 |
| 1790153625 | Jacob Mitchell | Counselor | 8500 Washington St Ne, Ste A1, Albuquerque, NM 87113-1846 | 2015-09-09 |
| Street Address |
1000 SE UGLOW AVE |
| City | DALLAS |
| State | OR |
| Zip Code | 97338-2645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497727127 | Tom L Flaming | Family Medicine | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2006-02-06 |
| 1932626132 | Harry Bret Schumilas | Family Medicine | 1000 Se Uglow Ave, Dallas, OR 97338 | 2017-08-28 |
| 1457751760 | Jessica Kingsbury | Nurse Practitioner | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2014-08-25 |
| 1164780060 | Wvp Medical Group, LLC | Clinic/Center | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2012-04-27 |
| 1700035565 | Kari Wattenbarger | Physician Assistant | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2008-09-16 |
| 1427247220 | Flaming Medical Center P.C. | Family Medicine | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2007-10-17 |
| 1336102201 | Anna U Severin | Physician Assistant | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2006-04-10 |
| 1740253103 | Jeffrey S Humphrey | Family Medicine | 1000 Se Uglow Ave, Dallas, OR 97338-2645 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164932042 | Stephanie Marie Renfro | Massage Therapist | 289 E Ellendale Ave #601, Dallas, OR 97338 | 2017-10-05 |
| 1588185953 | Herbert Starr Woodward IIi | Dentist | 201 Se Washington St, Dallas, OR 97338 | 2017-07-06 |
| 1851708077 | David Mooso | Pharmacist | 321 Nw Kings Valley Highway, Dallas, OR 97338 | 2014-07-21 |
| 1841615556 | Leslie Lytle | Counselor | 1020 Sw Maple St., Dallas, OR 97338 | 2014-03-04 |
| 1205265493 | Chung-fan Ni | Counselor | 182 S. W. Academy St., Academy Building, Dallas, OR 97338 | 2013-11-07 |
| 1215204300 | Ron Fritz | Counselor | 239 E. Ellendale, Suite 602, Dallas, OR 97338 | 2011-11-17 |
| 1235420167 | Deborah Kennedy | Counselor | 527 Ne Fern Ave, Dallas, OR 97338 | 2011-04-26 |
| 1821229774 | Chelsea Ruhoff Lee | Physician Assistant | 1000 Se Uglow Avenue, Flaming Medical Center, Dallas, OR 97338 | 2009-07-27 |
| 1013128560 | Larry J Vuylsteke | Social Worker | 182 S.w. Academy, Dallas, OR 97338 | 2007-05-25 |
| 1093926123 | Justin W Reed | Counselor | Academy Building, 182 S.w. Academy St. Suite 304, Dallas, OR 97338 | 2007-05-24 |
| Find all providers in zip 97338 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| 1225643562 | Yermiahu Levi Sarne | Physician Assistant | 6206 Preston Crest Ln, Dallas, TX 75230-1828 | 2020-09-14 |
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1275151102 | Kelly Ashworth | Physician Assistant | 7331 Gaston Ave # 180, Dallas, TX 75214-4131 | 2020-07-07 |
| 1780201715 | Gabriela Yvonne Camacho | Physician Assistant | 7331 Gaston Ave Unit 180, Dallas, TX 75214-4131 | 2020-06-25 |
| 1346879699 | Ws Neuroassist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-80, Dallas, TX 75214-6126 | 2020-04-07 |
| 1265065122 | Sarah Bell Stewart | Physician Assistant | 7811 Bryn Mawr Dr, Dallas, TX 75225-8217 | 2020-02-19 |
| 1093348237 | Meagan Lee Barry | Physician Assistant | 221 W Colorado Blvd Ste 431, Dallas, TX 75208-2312 | 2020-02-17 |
| 1245863554 | Melissa Ann Johnston | Physician Assistant | 4373 Boca Bay Dr, Dallas, TX 75244-7408 | 2020-02-14 |
| 1205479607 | Mj Surgical, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 906, Dallas, TX 75207-3912 | 2019-10-18 |
| Find all providers in DALLAS | ||||
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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.