DR. JERRY WAYNE MITCHELL (NPI# 1932289204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932289204 |
| Entity Type | Individual |
| Full Name | DR. JERRY WAYNE MITCHELL |
| Credential | D.D.S. |
| Practice Address |
620 First Ave N Ketchum ID 83340-0000 |
| Mailing Address |
Po Box 4378 620 First Ave N Ketchum ID 83340-0000 |
| Practice Telephone | 2087207368 |
| Mailing Telephone | 2087207368 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2012-12-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DE00005295 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033305529 | Jerry Dewayne Mitchell | Physical Therapy Assistant | 502 Wendover Ln, Bullard, TX 75757-5175 | 2007-09-19 |
| 1750500484 | Jerry Don Mitchell | Psychologist | Hwy 118 South, High Frontier, Fort Davis, TX 79734 | 2007-04-24 |
| 1497721914 | Jerry Mitchell | Anesthesiology | 2927 De La Vina St, Santa Barbara, CA 93105-3362 | 2006-02-24 |
| 1114447109 | Jerry Mitchell Jr. | Counselor | 19157 Crowley Eunice Hwy, Crowley, LA 70526 | 2017-06-21 |
| 1487930525 | Jerry Ray Mitchell | Internal Medicine | 6550 Mapleridge St Ste 201, Houston, TX 77081-4648 | 2011-11-02 |
| 1679674402 | Jerry E Mitchell | Surgery | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2006-09-26 |
| 1861445652 | Jerry W Mitchell | Radiology | 600 S 3rd St, Gadsden, AL 35901-5304 | 2006-05-19 |
| 1750339651 | Jerry Mitchell | Internal Medicine | 3100 Plaza Properties Blvd, Columbus, OH 43219-1530 | 2006-05-04 |
| Street Address |
620 FIRST AVE N |
| City | KETCHUM |
| State | ID |
| Zip Code | 83340-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779606 | Rooted Womens Health | Occupational Therapist | 431 N Walnut Ave, Ketchum, ID 83340 | 2020-10-29 |
| 1841826252 | Pilar Settlemier Tumolo | Counselor | 220 River Street East, Ketchum, ID 83340 | 2020-03-17 |
| 1598390643 | Alyson Holmes Witmer | Counselor | 220 2nd Ave, Ste 201, Ketchum, ID 83340 | 2020-03-10 |
| 1952864506 | Mollie Parker Szybala | Naturopath | 128 Saddle Rd, Suite 103-c, Ketchum, ID 83340 | 2019-04-10 |
| 1740789353 | Courtney Loving | Counselor | 208 N. Spruce, Ketchum, ID 83340 | 2018-02-09 |
| 1164876785 | Rebecca Grace | Psychologist | 200 River St East, Ketchum, ID 83340 | 2016-04-20 |
| 1306209556 | Garrett Coman | Dermatology | St. Luke's Dermatology, 191 5th Street West, Ketchum, ID 83340 | 2016-04-04 |
| 1265895775 | Innerhealth Md PC | Acupuncturist | 180 West 1st Street, Suite 206, Ketchum, ID 83340 | 2016-04-01 |
| 1487023503 | Tomomi Ikawa | Chiropractor | 131 4th St. E., Suite 310, Ketchum, ID 83340 | 2015-09-18 |
| 1790195766 | Maria Morris | Acupuncturist | 220 South 2nd Ave #101, Ketchum, ID 83340 | 2014-04-30 |
| Find all providers in zip 83340 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942587340 | James Walter Hodge | Dentist | 620 1st Avenue North, Ketchum, ID 83340-2273 | 2011-11-14 |
| 1043411697 | Herbert Aaron Blaser | Dentist | 181 1st Ave N, Ketchum, ID 83340 | 2007-05-30 |
| 1699976241 | Brian Cameron Galbraith | Dentist | 181 First Ave North, Ketchum, ID 83340 | 2007-05-30 |
| 1861600330 | Wayne Julian Spector | Dentist | 680 2nd Ave. North, Ketchum, ID 83340 | 2007-05-18 |
| 1962547174 | Cheryl N. Rice | Dentist | 191 Fifth St West, 2nd Floor, Ketchum, ID 83340 | 2007-02-21 |
| 1932305919 | Chris Michael Mazzola | Dentist | 181 1st Ave N, Ketchum, ID 83340 | 2007-06-26 |
| 1851496137 | Scott L Featherstone | Dentist | 191 Fifth Street West, Ketchum, ID 83340 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891304556 | Birchwood Dental, Pllc | Dentist | 3325 N Ten Mile Rd Ste 140, Meridian, ID 83646-6951 | 2020-07-29 |
| 1588273635 | Atlantis Dental Care, P.a. | Dentist | 13238 W Persimmon Ln Ste 100, Boise, ID 83713-1968 | 2020-07-24 |
| 1235747338 | Dentists of Boise and Orthodontics, PC | Dentist | 7500 W State St Ste 110, Boise, ID 83714-6074 | 2020-07-15 |
| 1346895232 | Tejasi Avasare | Dentist | 8321 W Overland Rd, Boise, ID 83709-1640 | 2019-08-07 |
| 1740835248 | Braden Comstock | Dentist | 2329 N Merritt Creek Loop, Coeur D Alene, ID 83814-4950 | 2019-08-02 |
| 1902450430 | Jaren M Thueson | Dentist | 106 E 1st N, Rexburg, ID 83440-1614 | 2019-08-01 |
| 1528610359 | Melissa Marie Pysnak | Dentist | 8850 W Emerald St Ste 150, Boise, ID 83704-4809 | 2019-07-11 |
| 1811555758 | Daniel Whitesitt | Dentist | 14596 Id-41, Rathdrum, ID 83858 | 2019-06-05 |
| 1104483122 | Meghan Cyrena Bristlin | Dentist | 3326 4th St Ste 3, Lewiston, ID 83501-4455 | 2019-05-24 |
| 1124684584 | Trevor Tafoya Dds Victory Dental, Pllc | Dentist | 7421 W Victory Rd, Boise, ID 83709-5106 | 2019-05-11 |
| Find all providers with the same taxonomy | ||||
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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.