DR. CARTER WALLACE MITCHELL (NPI# 1114123643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114123643 |
| Entity Type | Individual |
| Full Name | DR. CARTER WALLACE MITCHELL |
| Credential | M.D. |
| Practice Address |
18109 Prince Philip Dr Suite 325 Olney MD 20832-1519 |
| Mailing Address |
Po Box 418283 Boston MA 02241-8283 |
| Practice Telephone | 3017748958 |
| Practice Fax Number | 3017748959 |
| Mailing Telephone | 7035581544 |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2012-03-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
D0067371 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790300424 | Carter Mitchell | Dentist | 2850 Cahaba Rd Ste 140, Mountain Brk, AL 35223-2345 | 2020-06-09 |
| Street Address |
18109 PRINCE PHILIP DR SUITE 325 |
| City | OLNEY |
| State | MD |
| Zip Code | 20832-1519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407859085 | Edward Philip Taubman | Internal Medicine | 18109 Prince Philip Dr, Ste 275, Olney, MD 20832-1576 | 2005-05-27 |
| 1699395665 | Aly Dillon | Student in an Organized Health Care Education/Training Program | 18109 Prince Philip Dr, Olney, MD 20832-1519 | 2020-04-20 |
| 1841765740 | Lei Ma | Student in an Organized Health Care Education/Training Program | 18109 Prince Philip Dr, Olney, MD 20832-1519 | 2018-10-06 |
| 1831630227 | Jordan Doughty | Physical Therapy Assistant | 18109 Prince Philip Dr, Suite B-200, Olney, MD 20832-1519 | 2017-03-17 |
| 1023461951 | Shawn Chong | Physician Assistant | 18109 Prince Philip Dr, Suite 300, Olney, MD 20832-1519 | 2016-07-15 |
| 1134570898 | John Vipperman | Specialist/Technologist | 18109 Prince Philip Dr, Olney, MD 20832 | 2016-06-23 |
| 1932557139 | Shoshana Feldman | Registered Nurse | 18109 Prince Philip Dr, Olney, MD 20832-1519 | 2016-05-27 |
| 1649633140 | Mohammad Ahmad Safdar Ali | Internal Medicine | 18109 Prince Philip Dr, Olney, MD 20832-1519 | 2016-04-01 |
| 1265893515 | Capital Ob Gyn Specialists, Pa | Obstetrics & Gynecology | 18109 Prince Philip Dr, Suite 275, Olney, MD 20832-1519 | 2016-03-15 |
| 1023499738 | Joshua Lomke | Dentist | 18109 Prince Philip Dr, Suite 270, Olney, MD 20832-1519 | 2015-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443532 | Ludmila Costenco | Behavior Technician | 18218 Fox Chase Cir, Olney, MD 20832 | 2018-07-02 |
| 1912422874 | Shannon Denham Nguy | Nurse Practitioner | 18109 Prince Philip Dr Ste 300, Olney, MD 20832 | 2017-08-11 |
| 1578092904 | Rodney John Bohlmann | Naturopath | 17517 Queen Elizabeth Drive, Olney, MD 20832 | 2017-06-08 |
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1437547684 | Cynthia Ann Cook | Social Worker | 18006 Vintage River Terrace, Olney, MD 20832 | 2014-12-22 |
| 1598165334 | Gedion Haile | Pharmacist | 3110 Onley Sandy Spring Rd, Onley, MD 20832 | 2014-08-29 |
| 1285047902 | Melanie Ann Grady | Family Medicine | 18109 Prince Phillip Drive, Suite B200, Olney, MD 20832 | 2014-06-10 |
| 1063847267 | Mari Nako Tchantcho | Home Health Aide | 17149 Moss Side Lane, Olney, MD 20832 | 2013-09-06 |
| 1033558358 | Emily Sue Browning | Dentist | 3416 Olandwood Court, Suite 205, Suite 205, Olney, MD 20832 | 2013-06-19 |
| 1487093167 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 3414 Olandwood Court, Olney, MD 20832 | 2013-06-17 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952812208 | Richard Thomas Travis | Orthopaedic Surgery | 3113 Catrina Ln, Annapolis, MD 21403-4340 | 2017-10-13 |
| 1104180249 | Heather Suzanne York | Orthopaedic Surgery | 10975 Guilford Rd, Annapolis Junction, MD 20701-1125 | 2012-07-03 |
| 1598725442 | Scott P Worrell | Orthopaedic Surgery | 11110 Medical Campus Road, Suite 205, Hagerstown, MD 21742 | 2006-03-24 |
| 1215925128 | Jon D Koman | Orthopaedic Surgery | 116 Westminster Pike, Suite 100, Reisterstown, MD 21136-1027 | 2005-10-13 |
| 1083617625 | Orthopaedic and Sports Medicine Center LLC | Orthopaedic Surgery | 108 Forbes St, Annapolis, MD 21401-1502 | 2005-05-27 |
| 1023665262 | Johns Hopkins University | Orthopaedic Surgery | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2019-08-22 |
| 1811365828 | Lifebridge Community Physicians, Inc | Orthopaedic Surgery | 2401 W Belvedere Ave, Suite 102-104, Baltimore, MD 21215-5216 | 2015-09-08 |
| 1447636048 | Kessous & Kessous Md PC | Orthopaedic Surgery | 800 S Frederick Ave, Ste 100, Gaithersburg, MD 20877-4150 | 2015-08-05 |
| 1245632926 | Orthosurg Physician Assistants of Maryland LLC | Orthopaedic Surgery | 6430 Rockledge Dr, Suite 510, Bethesda, MD 20817-1805 | 2014-09-24 |
| 1437579596 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 5530 Wisconsin Ave, Suite 1660, Chevy Chase, MD 20815 | 2014-04-16 |
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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.