MR. DEREK KENNETH MIXON (DPT) – Physical Therapist, NPI 1235625377
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA
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Provider Addresses for MR. DEREK KENNETH MIXON (DPT)
4776 HODGES BLVD STE 101
JACKSONVILLE, FL 322247218
Phone: (904) 223-2363
Fax: (904) 223-2365
Type: Mailing
Shawnee Road, Lima, Allen County, Ohio, 45805, United States
LIMA, OH 458053529
Phone:
Type: Mailing
Three Tree Medical Arts Building, 16259, Sylvester Road Southwest, Five Corners, Burien, King County, Washington, 98166, United States
BURIEN, WA 981663049
Phone: (206) 242-5186
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-02-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230201000541 | I | Physical Therapist In Private Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1,022 | 76 | $0 |
| 97530 | Therapy procedure using functional activities | 1,021 | 74 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 727 | 71 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 655 | 65 | $0 |
| 97116 | Therapy procedure for walking training, each 15 minutes | 101 | 20 | $0 |
Insurance plans in this area (ZIP 32224)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| Physical Therapist In Private Practice | AL | |
| Physical Therapist In Private Practice | FL | |
| - | FL | |
| Physical Therapist In Private Practice | FL |
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