Individual provider Active NPI

Justin Douglas Mitchell, PT

  • Physical Therapist
  • Rock Hill, SC
National Provider Identifier
1093775322
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3834 Issued in SC
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

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
E1570OtherMEDCOST
0788COtherNCBLUE 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
Celcor CorporationGroup PAC ID 8123486313, 3 clinicians

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

LicenseStateTypeSpecialty
6620NCMDPhysical Therapist
3834SCMDOccupational 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.

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.

Verify at the official NPI Registry.