Kenneth Paul Mitchell, MD
Family Medicine, Bariatric Medicine in Niceville, FL. Individual provider (NPI-1).
NPI number1477542850
StatusActive
Last updated in NPPESJan 12, 2021
Details
- NPI
- 1477542850
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Paul Mitchell
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2005
- Certification date
- Jan 12, 2021
- Last updated
- Jan 12, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - GENERAL PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QB0002X | Family Medicine, Bariatric Medicine | ME48856 | FL | Yes |
| 207VG0400X | Obstetrics & Gynecology, Gynecology | ME48856 | FL |
Practice location
2600 Partin Dr N Ste 110Niceville, FL 32578-1543
Phone 850-517-6578
Mailing address
910 Royce StPensacola, FL 32503-2464
Phone 850-444-4997 · Fax 850-444-4992
Other practice locations
910 Royce St
Pensacola, FL 32503-2464
Pensacola, FL 32503-2464
Phone 850-444-4997 · Fax 850-444-4992
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.