MEDICARE: ALEXIS MITCHELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist		NC

General Provider Information

NPI Number	:	1053267476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS MITCHELL

Provider Business Mailing Address
First Line	:	2431 RADRICK LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2431 RADRICK LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4442
Country	:	US
Telephone Number	:	980-415-5638
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ ALEXIS MITCHELL ” Practice Location

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