William Thomas Mixon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012275 Issued in GA

Practice address

620 J L White Dr Ste 110
Jasper, GA 30143-4897

Phone

(706) 692-9080

Fax

(706) 692-1199

NPI assigned

Apr 22, 2016

Last updated

Jan 24, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advance Rehabilitation and Consulting Limited PartnershipGroup PAC ID 4082890645, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Advance Rehabilitation & Consulting Limited Partnership

  • Physical Therapist
  • Saint Marys, GA
  • NPI 1235434283
  Medicare reassignment Care Compare group NPD
• Advance Rehabilitation & Consulting Limited Partnership

  • Durable Medical Equipment & Medical Supplies
  • Jasper, GA
  • NPI 1164115671

  Physical Therapist

  NPD

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1841644283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OSIGIAN BLVD",
            "address_2": "SUITE 300",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888968",
            "telephone_number": "478-333-3075",
            "fax_number": "478-333-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 J L WHITE DR STE 110",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434897",
            "telephone_number": "706-692-9080",
            "fax_number": "706-692-1199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Osigian Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310888968",
            "country_code": "US",
            "telephone_number": "478-333-3075",
            "fax_number": "478-333-3484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIXON",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Jasper, GA
• Providers in Jasper, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.