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MR. ROBERT DAVID MIXSON M.D.
NPI 1912904459
Specialist in Saint Marys, GA

Active since June 30, 2005PECOS Enrolled
104 LAKESHORE DR, STE A, SAINT MARYS, GA 31558(912) 882-7100(912) 882-9149 Get Directions Write a Review

NPPES record last updated: September 3, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mr. Robert David Mixson M.d. NPPES

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

MR. ROBERT DAVID MIXSON M.D. (NPI 1912904459) is an individual specialist in Saint Marys, Georgia, licensed in Georgia (039415) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912904459
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameMR. ROBERT DAVID MIXSONCredential: M.D.
Location Address104 LAKESHORE DR, STE ASaint Marys, GA 31558-3803
Mailing Address104 Lakeshore Dr, Ste ASaint Marys, GA 31558-3803 · (912) 882-7100 · Fax (912) 882-9149
Phone(912) 882-7100
Fax(912) 882-9149
Sole ProprietorYes
Enumeration DateJune 30, 2005
Last NPPES UpdateSeptember 3, 2015
✔ NPI 1912904459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in GA · 039415
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
104 LAKESHORE DR, Saint Marys, GA 31558
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Robert David Mixson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Robert Mixson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cooperative Healthcare Services Inc
28 mi
Clinic/Center
2415 PARKWOOD DR
Brunswick, GA 31520
  • Reassigned Medicare billing, Georgia enrollment
  • 339 clinicians in this Medicare group
NPI 1417979402 (912) 466-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 7

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

CJ MATHIS CFA
104 LAKESHORE DR, SUITE B
SAINT MARYS, GA 31558
Camden County (912) 673-1771
MRS. DELMA CHRISTINE JAY BSPA-CAC II
Counselor (Addiction (Substance Use Disorder))
104 LAKESHORE DR
SAINT MARYS, GA 31558
Camden County (912) 729-1120
TERESA NICHOLSON CNM
Advanced Practice Midwife
104 LAKESHORE DR, STE A
SAINT MARYS, GA 31558
Camden County (912) 882-7100
DR. BONNIE RENEE SPENCER LAPC
Counselor (Professional)
104 LAKESHORE DR, SUITE D
SAINT MARYS, GA 31558
Camden County (912) 729-1120
ROBERT D. MIXSON MD PA A GEORGIA CORP
Obstetrics & Gynecology
104 LAKESHORE DR, STE A
SAINT MARYS, GA 31558
Camden County (912) 882-7100
COASTAL COUNSELING CENTER, INC.
Community/Behavioral Health
104 LAKESHORE DR, SUITE D
SAINT MARYS, GA 31558
Camden County (912) 729-1120
SONYA L COWART LAPC
Counselor (Professional)
104 LAKESHORE DR, STE D
SAINT MARYS, GA 31558
Camden County (912) 729-1120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Mixson's NPI number?

The NPI number for Robert Mixson is 1912904459. It was assigned to this individual provider in the NPPES registry on June 30, 2005.

Where is Robert Mixson located?

Robert Mixson practices at 104 Lakeshore Dr Ste A, Saint Marys, GA 31558. The listed phone number is (912) 882-7100.

What is Robert Mixson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Robert Mixson enrolled in Medicare?

Yes. Robert Mixson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Robert Mixson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Mixson reassigns Medicare benefits to Cooperative Healthcare Services Inc (Brunswick, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Mixson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Robert Mixson was last updated on September 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.