John Michael Mitchelson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP014507T Issued in VA

Practice address

43490 Yukon Dr Ste 212
Ashburn, VA 20147-7326

Phone

(703) 729-7920

Fax

(703) 729-7923

NPI assigned

Jul 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1194100578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1769",
            "city": "MIDDLEBURG",
            "state": "VA",
            "postal_code": "201181769",
            "telephone_number": "703-729-7920",
            "fax_number": "703-729-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43490 YUKON DR STE 212",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201477326",
            "telephone_number": "703-729-7920",
            "fax_number": "703-729-7923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 S Arrowhead Dr",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640556952",
            "country_code": "US",
            "telephone_number": "816-795-6999",
            "fax_number": "816-795-3366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELSON",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-27",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP014507T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2015017637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bibhu R Misra, D.C., M.SC.
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• Rhyan A Mitchell, LRC
• Mna Innovations LLC
• Courtney Amber Moats, M.D.
• Anousheh Mohandes Tarighi, MSN, APRN, FNP-BC
• Peyam Mojallal, OD
• Lina Mojarrad, OD

• Physical Therapist in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.