Active NPI
Justice Mixson
- Physical Rehabilitation Occupational Therapist
- Jacksonville, FL
National Provider Identifier
1760110936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- Practice address
- 3688 Dillon Street
Jacksonville, FL 32254 - Phone
- (904) 401-1368
- NPI assigned
- Aug 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | Primary |
Addresses
Primary practice location
3688 Dillon Street
Jacksonville, FL 32254
Mailing address
3688 Dillon Street
Jacksonville, FL 32254
Phone (904) 401-1368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare Group East, LLC | Past | Accepting new patients |
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.
-
- Rehabilitation Clinic/Center
- Shalimar, FL
- NPI 1407382278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1760110936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3688 DILLON STREET",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32254",
"telephone_number": "904-401-1368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3688 DILLON STREET",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32254",
"telephone_number": "904-401-1368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIXSON",
"first_name": "JUSTICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-15",
"last_updated": "2022-08-15",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.