Jessie Mizzell, PT/DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12212 Issued in SC

Practice address

119 Office Park Dr
Orangeburg, SC 29118-2407

Phone

(803) 937-5605

Fax

(803) 937-6256

NPI assigned

Apr 18, 2024

Last updated

Apr 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessie Funchess Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Works Physical Therapy LLCGroup PAC ID 1951711597, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Works Physical Therapy, LLC

  dba The Works Physical Therapy

  • Physical Therapist
  • Bamberg, SC
  • NPI 1215543541
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1639924277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3374 RAILROAD AVE",
            "city": "BAMBERG",
            "state": "SC",
            "postal_code": "290038248",
            "telephone_number": "803-245-0808",
            "fax_number": "803-245-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OFFICE PARK DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291182407",
            "telephone_number": "803-937-5605",
            "fax_number": "803-937-6256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3374 Railroad Ave",
            "address_purpose": "LOCATION",
            "city": "Bamberg",
            "state": "SC",
            "postal_code": "290038248",
            "country_code": "US",
            "telephone_number": "803-245-0808",
            "fax_number": "803-245-0974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZZELL",
        "first_name": "JESSIE",
        "credential": "PT/DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "FUNCHESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ruthie Joane Miller, M.ED., LPC
• Megan Millhouse
• Jessica Henrietta Mills, FNP-BC
• William Walton Mims Jr., M.D.
• Minds Moving Forward
• Mmo Investments LLC (McDental Better Sleep)
• Modlin & Londry Xiv LLC (Garden City Dental)
• Andrea Moore
• Catherine Hammond Moore, PA-C
• Dorwin Tillman Moore, MD

• Physical Therapist in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.