Individual provider Active NPI

Justin Corbin Mitchell, PT

  • Physical Therapist
  • Derby, KS
National Provider Identifier
1982804332
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-03235 Issued in KS
Practice address
1101 N Rock Rd Ste 300
Derby, KS 67037-3798
Phone
(316) 260-3311
Fax
(316) 260-6696
NPI assigned
Jul 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-03235 KS Primary

Addresses

Primary practice location

1101 N Rock Rd Ste 300
Derby, KS 67037-3798

Mailing address

1101 N Rock Rd Ste 300
Derby, KS 67037-3798
Phone (316) 260-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000787 KS Practitioner - Physical Therapist in Private Practice 6204024383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Physical Therapy LLCGroup PAC ID 3779914544, 50 clinicians
Mid-America Orthopedics LLCGroup PAC ID 1850455759, 30 clinicians

Practice addresses (Care Compare)

12627 E Central Ave
Suite 308
Wichita, KS 67206-2839
Phone (316) 260-3311

1923 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 630-9300

1927 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 630-9300

Merit-based Incentive Payment System (MIPS)

Final score
79.9 of 100Reported as group
Quality
62.85
Promoting interoperability
99
Improvement activities
40
Cost
70.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Physical Therapy LLC CurrentSince Nov 1, 2025 Accepting new patients
Mid-America Orthopedics LLC CurrentSince Dec 8, 2010 Accepting new patients
Mid-America Orthopedics LLC Past Accepting new patients
Mid-America Orthopedics, P.a. Past Accepting new patients

Locations

1101 N Rock Rd
Ste 300
Derby, KS 67037
Phone (316) 425-2400

1824 E James St
Derby, KS 67037
Phone (316) 630-9300

1635 Freedom St
Ste 900
Derby, KS 67037
Phone (316) 630-9300

12627 E Central Ave
Wichita, KS 67206

12627 E Central Ave
Ste 308
Wichita, KS 67206

3223 N Webb Rd
Ste 2
Wichita, KS 67226
Phone (316) 609-3040

1923 N Webb Rd
Wichita, KS 67206
Phone (316) 262-4886

Interoperability endpoints

  • Direct secure messaging: justin.mitchell.1@26355.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1982804332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N ROCK RD STE 300",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373798",
            "telephone_number": "316-260-3311",
            "fax_number": "316-260-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N ROCK RD STE 300",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373798",
            "telephone_number": "316-260-3311",
            "fax_number": "316-260-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JUSTIN",
        "middle_name": "CORBIN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.