Jonathan Bennett Hixson, DPT
NPI 1740815786ActiveIndividual· Physical Therapist· Clover, SC
Physical Therapist (DPT) with Custom Physical Therapy and Fitness, practicing in Clover, South Carolina. Enrolled in Medicare as practitioner - physical therapist in private practice and practitioner - physical therapist in private practice.
Overview
| NPI | 1740815786 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Mar 10, 2020 |
| Last updated in NPPES | Apr 27, 2020 |
| Certified by provider | Apr 27, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | P19378 | NC |
| Physical Therapist | 225100000X | 10169 | SC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NC); Practitioner - Physical Therapist in Private Practice (SC) |
|---|
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Custom Physical Therapy and FitnessMcAdenville, NC · 6 clinicians
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