Individual provider Active NPI

Joshua Alexander Jividen, DPT

  • Physical Therapist
  • Dayton, OH
National Provider Identifier
1083405575
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
715 Congress Park Dr
Dayton, OH 45459-4044
Phone
(937) 660-7638
NPI assigned
May 14, 2025
Last updated
May 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X OH Primary

Addresses

Primary practice location

715 Congress Park Dr
Dayton, OH 45459-4044

Mailing address

6411 Reverie LN
Dayton, OH 45449-3536
Phone (937) 838-2192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250619000330 OH Practitioner - Physical Therapist in Private Practice 3274044870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Cincinnati College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

715 Congress Park Dr
Centerville, OH 45459-4044
Phone (513) 802-1929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobility Fit Physical Therapy LLC Physical Therapist Current Accepting new patients
Mobility Fit Physical Therapy LLC Physical Therapist CurrentSince May 19, 2025 Accepting new patients
Mobility Fit Physical Therapy, LLC Physical Therapist CurrentSince May 19, 2025 Accepting new patients

Locations

2080 Beaver Valley Rd
Beavercreek, OH 45434
Phone (513) 802-1929

11125 Kenwood Rd
Blue Ash, OH 45242
Phone (513) 791-4040

801 W Main St
Lebanon, OH 45036
Phone (513) 491-0888

715 Congress Park Dr
Washington Township, OH 45459
Phone (513) 802-1929

7753 Cox Ln
West Chester, OH 45069
Phone (303) 710-0515

7782 Service Center Dr
West Chester, OH 45069
Phone (303) 710-0515

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1083405575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 REVERIE LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454493536",
            "telephone_number": "937-838-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CONGRESS PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594044",
            "telephone_number": "937-660-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIVIDEN",
        "first_name": "JOSHUA",
        "middle_name": "ALEXANDER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.