DR. CHARLES AUSTIN JR. MITCHELL (MD) – Dermatology Physician, NPI 1063409845

DR. CHARLES AUSTIN JR. MITCHELL (MD) is a healthcare provider. based in Lebanon, Tennessee. specializing in Dermatology Physician. They hold the professional credentials MD. They hold a License No. MD7104 (TN). The NPI Number for DR. CHARLES AUSTIN JR. MITCHELL (MD) is 1063409845

Main info

Male
Sole Proprietor
56 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHARLES AUSTIN JR. MITCHELL (MD)
NPI
1063409845
Phone
(615) 443-4112
Address
206B BABB DR
Enumeration Date
5 October 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
6154434112
Graduation Year
1970 (56 years ago)
PAC ID
8628971116
Group Practice PAC ID
0941391338
Professional Enrollment ID
I20110406000644
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. CHARLES AUSTIN JR. MITCHELL (MD)

  • Babb Drive, Lebanon, Wilson County, Middle Tennessee, Tennessee, United States

    LEBANON, TN 370872508

    Phone: (615) 443-4112

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 28 Open Payments records for all available years, with a total value of $491.

Total Amount is formed as General ($491) + Research ($0) + Ownership ($0) = $491.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($134).

Total Amount

$491

General + Research + Ownership

Payments

28

Total payment records

General Amount

$491

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2011-04-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110406000644IDermatologyTNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 37087)

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Provider's Procedures

DR. CHARLES AUSTIN JR. MITCHELL (MD) performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYTN17003Destruction of 2-14 skin growths1556286

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941391338View full group profile
NameSpecialtyState
Nurse PractitionerTN
Physician AssistantTN
D E R M A T O L O G YTN
D E R M A T O L O G YTN
Nurse PractitionerTN
Physician AssistantTN
Physician AssistantAR
Physician AssistantTN
D E R M A T O L O G YTN
D E R M A T O L O G YTN

Reviews

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Frequently asked questions

What is the standard ID for DR. CHARLES AUSTIN JR. MITCHELL (MD) in the U.S.?
In the U.S., DR. CHARLES AUSTIN JR. MITCHELL (MD) is identified by NPI 1063409845.
Does the public listing show DR. CHARLES AUSTIN JR. MITCHELL (MD) as active?
DR. CHARLES AUSTIN JR. MITCHELL (MD)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. CHARLES AUSTIN JR. MITCHELL (MD)'s specialty?
The extract shows Dermatology Physician for DR. CHARLES AUSTIN JR. MITCHELL (MD). Clinical services aligned with this taxonomy classification.
Is DR. CHARLES AUSTIN JR. MITCHELL (MD) tied to Lebanon, Tennessee?
If you are local to Lebanon, Tennessee, DR. CHARLES AUSTIN JR. MITCHELL (MD) may be relevant to your search.
Can I export DR. CHARLES AUSTIN JR. MITCHELL (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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