Individual provider Active NPI

Jill Christina Mitchell, DPT

  • Physical Therapist
  • Plano, TX
National Provider Identifier
1992053219
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1219621 Issued in TX
Practice address
6300 W Parker Rd Ste G21
Plano, TX 75093-8105
Phone
(972) 981-8185
NPI assigned
Aug 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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 1219621 TX Primary

Addresses

Primary practice location

6300 W Parker Rd Ste G21
Plano, TX 75093-8105

Mailing address

125 N Windomere Ave
Dallas, TX 75208-5331
Phone (972) 741-6632

Other practice location 1

16250 Knoll Trail Dr Ste 101
Dallas, TX 75248-2868
Phone (214) 679-3891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221119000076 TX Practitioner - Physical Therapist in Private Practice 6901040781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Ellen NguyenGroup PAC ID 5597195404, 4 clinicians

Practice addresses (Care Compare)

16250 Knoll Trail Dr
Dallas, TX 75248-2874
Phone (214) 679-3891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Ellen Nguyen Physical Therapist CurrentSince Oct 30, 2022 Accepting new patients
Thrive Physio and Wellness, PLLC CurrentSince Oct 24, 2021 Accepting new patients
Holistic Pain Management of Wyoming, LLC PastSince Mar 27, 2017 Accepting new patients

Locations

16250 Knoll Trail Dr
Ste 101
Dallas, TX 75248
Phone (214) 679-3891

Organizations & group practices 3

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": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1992053219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N WINDOMERE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085331",
            "telephone_number": "972-741-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE G21",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938105",
            "telephone_number": "972-981-8185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16250 Knoll Trail Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752482868",
            "country_code": "US",
            "telephone_number": "214-679-3891",
            "fax_number": "469-405-2994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JILL",
        "middle_name": "CHRISTINA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1219621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.