JESSE JR. MITCHELL (M.D.) – Emergency Medicine Physician, NPI 1063479863
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,513 EMERGENCY MEDICINE in GA
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Provider Addresses for JESSE JR. MITCHELL (M.D.)
4839 POOL MILL RD
DOUGLASVILLE, GA 301355266
Phone:
Type: Mailing
Tanner Medical Center, 705, Dixie Street, Carrollton, Carroll County, Georgia, 30117, United States
CARROLLTON, GA 301173818
Phone: (770) 836-9666
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-01-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050120000623 | I | Emergency Medicine | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 414 | 47 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 162 | 146 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 122 | 91 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 96 | 26 | $0 |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 95 | 92 | $0 |
Insurance plans in this area (ZIP 30135)
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