JACK MIXON (NPI# 1497204739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497204739 |
| Entity Type | Individual |
| Full Name | JACK MIXON |
| Credential | RKT |
| Practice Address |
41 Park Creek Dr Greenville SC 29605-4270 |
| Practice Telephone | 8642991600 |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 226300000X | Kinesiotherapist | 1982 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
41 PARK CREEK DR |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548243264 | April Keen | Nutritionist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2005-11-28 |
| 1508464991 | Ashley Popham | Physical Therapist | 41 Park Creek Dr, Greenville, SC 29605-2960 | 2020-10-16 |
| 1285241745 | Nathan Andrew Hogue | Social Worker | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2020-09-29 |
| 1598370769 | Anna Blythe Bottino | Nurse Practitioner | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2020-09-14 |
| 1578101242 | Jamie Nagle | Dental Hygienist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-12-12 |
| 1265086953 | Kirstie Brooke Jackson | Licensed Practical Nurse | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-07-31 |
| 1275192874 | Maggie Estelle Asman | Student in an Organized Health Care Education/Training Program | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-06-07 |
| 1205494580 | Tandi Gilmore | Nurse Practitioner | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-06-03 |
| 1194288670 | Haminah Laverne Johnson | Social Worker | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2019-04-10 |
| 1578057600 | Elora Ommen | Optometrist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2018-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 226300000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Kinesiotherapist |
| A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designed to improve the quality of line and health of adults and children by developing physical fitness, increasing mobility and independence, and improving psychosocial behavior. The kinesiotherapist seeks a coach-player relationship in which he/she helps the patient/client reach the goal of becoming an independent, self-sustaining person. Kinesiotherapists, as compared with physical therapists, put more emphasis on geriatric care, reconditioning and fitness, and psychiatric care. A large percentage of kinesiotherapists practice in Veterans Administration hospitals. |
| Notes: Source: The Kinesiotherapy Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407336068 | Carmel Sewer | Kinesiotherapist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2018-08-14 |
| 1710383104 | Eulela Flemming | Kinesiotherapist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2014-11-12 |
| 1699197152 | Keshia Mcmillian | Kinesiotherapist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2014-01-17 |
| 1518177666 | Alan Bruce Simmerson | Kinesiotherapist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2007-05-23 |
| 1154432185 | Wade Duncan Sparks | Kinesiotherapist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2006-08-31 |
| 1639186893 | Robert A Hale | Kinesiotherapist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2006-08-01 |
| City | GREENVILLE |
| Zip Code | 29605 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.