Active NPI
Justin Douglas Mitchell, PT
- Physical Therapist
- Rock Hill, SC
National Provider Identifier
1093775322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3834
- Practice address
- 1393 Celanese Rd
Rock Hill, SC 29732-1722 - Phone
- (803) 329-3103
- Fax
- (803) 325-2232
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P6620 | NC | |
| Physical Therapist | 225100000X | 3834 | SC | Primary |
Addresses
Primary practice location
1393 Celanese Rd
Rock Hill, SC 29732-1722
Mailing address
1393 Celanese Rd
Rock Hill, SC 29732-1722
Phone (803) 329-3103
Other practice location 1
6425 W Wilkinson Blvd Ste D
Belmont, NC 28012-3089
Phone (704) 774-8190
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E1570 | Other | MEDCOST | |
| 0788C | Other | NC | BLUE CROSS BLUE SHIELD NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6425 Wilkinson Boulevard
Belmont, NC 28012-2873
Phone (704) 774-8190
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6620 | NC | MD | Physical Therapist |
| 3834 | SC | MD | Occupational Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba FYZICAL Therapy & Balance Centers-Belmont
- Physical Therapist
- Belmont, NC
- NPI 1770280240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1093775322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1393 CELANESE RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321722",
"telephone_number": "803-329-3103",
"fax_number": "803-325-2232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1393 CELANESE RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321722",
"telephone_number": "803-329-3103",
"fax_number": "803-325-2232"
}
],
"practiceLocations": [
{
"address_1": "6425 W Wilkinson Blvd Ste D",
"address_purpose": "LOCATION",
"city": "Belmont",
"state": "NC",
"postal_code": "280123089",
"country_code": "US",
"telephone_number": "704-774-8190",
"fax_number": "704-774-8190",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "JUSTIN",
"middle_name": "DOUGLAS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P6620",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "3834",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "E1570",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD NC",
"identifier": "0788C",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.