Jonathan Bennett Hixson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P19378 Issued in NC

Practice address

4543 Charlotte Hwy Ste 11
Clover, SC 29710-7057

Phone

(803) 831-1454

NPI assigned

Mar 10, 2020

Last updated

Apr 27, 2020By the provider in NPPES

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

Enrolled in SC, NC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Custom Physical Therapy and FitnessGroup PAC ID 5890192595, 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.

• Custom Physical Therapy and Fitness

  • Physical Therapist
  • Cramerton, NC
  • NPI 1063083384
  Medicare reassignment Care Compare group NPD
• Lifestyle Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Clover, SC
  • NPI 1962687467
  Medicare reassignment NPD

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1740815786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 PARK SOUTH STATION BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104553",
            "telephone_number": "336-543-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 CHARLOTTE HWY STE 11",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297107057",
            "telephone_number": "803-831-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIXSON",
        "first_name": "JONATHAN",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10169",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harris Teeter, LLC (Harris Teeter Pharmacy #015)
• Thomas Wesley Hartlage, PT, DPT
• Heisalive,LLC (Medcare Pharmacy)
• Edward Lawson Held, MD
• Elijah Nathaniel Helm, BSW, MSW, LCSW(A)
• Michael James Holtel, RPH
• Johnny Jay Horace, R.PH
• Holly Lynn Horn, LPCA
• Joseph H. Hourihan, D.M.D.
• Michael Howe, PHARMD

• Physical Therapist in Clover, SC
• Providers in Clover, 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 27, 2020; 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.