DR. DERRECK DIXON (PT, DPT) – Physical Therapist, NPI 1003537861

DR. DERRECK DIXON (PT, DPT) is a healthcare provider. based in Stafford, Virginia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 2305215314 (VA). The NPI Number for DR. DERRECK DIXON (PT, DPT) is 1003537861

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. DERRECK DIXON (PT, DPT)
NPI
1003537861
Phone
(757) 803-5630
Address
5 BRUCE ST
Enumeration Date
8 September 2022
Last Update Date
8 September 2022

Doctor Profile

Medical School Name
MARYMOUNT UNIVERSITY
Secondary Phone
5714274378
Graduation Year
2022 (4 years ago)
PAC ID
8426425604
Group Practice PAC ID
4486081007
Professional Enrollment ID
I20221031002771
Address ID
VA225547257ST124XXRDXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

3,080 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VA

Provider Addresses for DR. DERRECK DIXON (PT, DPT)

  • 5 BRUCE ST

    STAFFORD, VA 225546581

    Phone: (757) 803-5630

    Type: Mailing

  • 4701 SPOTSYLVANIA PKWY STE 106

    FREDERICKSBURG, VA 224079435

    Phone: (540) 710-0100

    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: 2022-10-31

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221031002771IPhysical Therapist In Private PracticeVATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,307108$0
97140Therapy procedure using manual technique, each 15 minutes80081$0
97530Therapy procedure using functional activities47976$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes28547$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care21240$0
View full utilization report →

Insurance plans in this area (ZIP 22554)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486081007View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA

Reviews

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Frequently asked questions

Is DR. DERRECK DIXON (PT, DPT) listed with a National Provider Identifier?
Yes — DR. DERRECK DIXON (PT, DPT) has NPI 1003537861 on file in the registry.
Active or inactive — what applies to DR. DERRECK DIXON (PT, DPT)?
You should see DR. DERRECK DIXON (PT, DPT) as active in CMS-hosted NPPES data.
How would a patient describe DR. DERRECK DIXON (PT, DPT)'s focus?
For DR. DERRECK DIXON (PT, DPT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Where in Virginia is DR. DERRECK DIXON (PT, DPT) registered?
Use Stafford, Virginia as the headline location for DR. DERRECK DIXON (PT, DPT) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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