Corbin Mixon, DC
Individual provider Active NPI Chiropractor · Springfield, MO
NPI 1134812878 · NPPES record last updated May 30, 2023
Key facts
- NPI
- 1134812878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2023016890 (MO)
- Practice address
- 3952 S Fairview Ave
Springfield, MO 65807-4604 - Phone
- (417) 885-9078
- NPI assigned
- May 30, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
591 E Elm St
Republic, MO 65738-1317
Phone (417) 987-2444
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240920003326 | MO | Practitioner - Chiropractic | 8426599101 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back in Balance | Chiropractor | Current |
Accepting new patients |
| Mitchell Chiropractic and Rehabilitation Center, LLC | Chiropractor | Current |
Accepting new patients |
Locations
591 E Elm St
Republic, MO 65738
Phone (417) 987-2444
3952 S Fairview Ave
Springfield, MO 65807
Phone (417) 885-9078
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2023016890 | MO | Yes |
Addresses
Primary practice location
3952 S Fairview Ave
Springfield, MO 65807-4604
Mailing address
681 N Montego St
Nixa, MO 65714-9183
Phone (620) 875-0769
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.