Physician Compare National (NPI:1326562034)

HEALTHCARE PROVIDER: ROGER MITCHELL DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1326562034
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103198692
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190722003436
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MITCHELL
	Individual professional last name
Provider First Name	ROGER
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LIFE CLINIC OF NJ DC PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4789917626
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	145 COMMONS WAY
	Group Practice or individual's line 1 address
City	BRIDGEWATER
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	088072801
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9088005158
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y