PATRICIA MIXON
NPI 1720652068
Social Worker - Clinical in Carterville, IL

Q: What is Patricia Mixon's NPI number?

The NPI number for Patricia Mixon is 1720652068. It was assigned to this individual provider in the NPPES registry on May 19, 2021.

Q: What is Patricia Mixon's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Patricia Mixon was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 19, 2021PECOS EnrolledAccepts Medicare Assignment

403 MUNICIPAL DR, CARTERVILLE, IL 62918(855) 608-3561(618) 956-9349 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 27, 2025, May 19, 2021 (2 updates tracked since 2021).

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About Patricia Mixon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PATRICIA MIXON (NPI 1720652068) is an individual clinical provider in Carterville, Illinois, licensed in Illinois (149028869) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1720652068

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NamePATRICIA MIXON

Location Address403 MUNICIPAL DRCarterville, IL 62918-2042

Mailing Address902 W Main StWest Frankfort, IL 62896-2210 · (618) 937-6483 · Fax (618) 937-1440

Phone(855) 608-3561

Fax(618) 956-9349

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMay 19, 2021

Last NPPES UpdateFebruary 27, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 27, 2025

✔ NPI 1720652068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IL · 149028869

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedSocial WorkerTaxonomy 104100000X · License 150.105149 (IL)

403 MUNICIPAL DR, Carterville, IL 62918

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Patricia Mixon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719401827

PECOS Enrollment IDI20250410001916

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62918 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $54.80 – $168.44

Typical copayment $0.00 (range $13.70 – $42.11)

Most-billed visit code NA

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JODI BRADLEY ADN, RN

Registered Nurse