SALLY ANN MITCHELL (CAA) – Anesthesiologist Assistant, NPI 1265517601
Anesthesiologist Assistant
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Profile Insights
NPPES metrics only — not quality of care.
204 ANESTHESIOLOGY ASSISTANT in IN
Provider Addresses for SALLY ANN MITCHELL (CAA)
3016 EGLANTINE CT
MARIETTA, GA 300624988
Phone:
Type: Mailing
705 Riley Hospital Dr
Indianapolis, IN 462025109
Phone: (317) 274-0275
Fax: (317) 274-0256
Type: Location
550 Peachtree St
Atlanta, GA 30308
Phone: (404) 778-4852
Type: Location
FPHO MANAGED CARE
1102 WEST 32ND STREET
JOPLIN, MO 64804
Phone:
Fax: (417) 347-5033
Type: Mailing
1102 W 32ND ST
JOPLIN, MO 648043503
Phone: (417) 347-5222
Type: Location
550, Peachtree Street Northeast, Atlanta, Georgia, 30308, United States
ATLANTA, GA 30308
Phone: (404) 778-4852
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: 2024-08-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20161219002145 | I | Anesthesiology Assistant | IN | TBD |
| I20240829003045 | I | Anesthesiology Assistant | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30062)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| - | MO | |
| - | MO | |
| Nurse Practitioner | KS | |
| U R O L O G Y | MO | |
| R H E U M A T O L O G Y | MO | |
| Nurse Practitioner | MO | |
| H E M A T O L O G Y/ O N C O L O G Y | MO | |
| - | MO | |
| Sleep Medicine, Pulmonary Disease, Critical Care (Intensivists) | MO |
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