THADEUS MIXON – Occupational Therapist, NPI 1366199465

THADEUS MIXON is a healthcare provider. based in Reedville, Virginia. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for THADEUS MIXON is 1366199465

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
THADEUS MIXON
NPI
1366199465
Phone
(607) 377-2867
Address
746 OYSTER POINT DR
Enumeration Date
8 March 2022
Last Update Date
8 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9073980411
Graduation Year
2020 (6 years ago)
PAC ID
9436661857
Group Practice PAC ID
6800864604
Professional Enrollment ID
I20250623001628
Address ID
AK996697103SO35932HWYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:4State licenses:0Digital endpointsOther names

1,224 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for THADEUS MIXON

  • 746 OYSTER POINT DR

    REEDVILLE, VA 225393605

    Phone: (607) 377-2867

    Type: Mailing

  • 2836 MARIGOLD AVE

    CHICO, CA 959737624

    Phone: (607) 377-2867

    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: 2025-06-23

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
I20250623001628IOccupational Therapist In Private PracticeAKTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22539)

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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: 6800864604View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeMT
Physical Therapist In Private PracticeAK
Occupational Therapist In Private PracticeNC
Physical Therapist In Private PracticeSC
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeAK

Reviews

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Frequently asked questions

Can I cross-check THADEUS MIXON using NPI 1366199465?
NPI 1366199465 belongs to THADEUS MIXON; compare other details if you need extra assurance.
Active or inactive — what applies to THADEUS MIXON?
You should see THADEUS MIXON as active in CMS-hosted NPPES data.
What area of care is associated with THADEUS MIXON?
THADEUS MIXON's record emphasizes Occupational Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with THADEUS MIXON?
Directory geography for THADEUS MIXON centers on Reedville, Virginia.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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