Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Justin T Mizelle, PA-C

Individual provider Medical Physician Assistant · NPI 1356623391

Mr. Justin T Mizelle, PA-C is a Physician Assistant in Johnson City, Tennessee. Qualified in 2011, 15 years ago. Practices with Watauga Orthopaedics PLC, a 82-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
15
Licensed in
TN
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone: (888) 632-1085
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 301 Med Tech Pkwy Ste 200, Johnson City, TN 37604-2364 — (423) 794-1300

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2025 (TN)

Record details

NPI number1356623391
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 15, 2011
Last updated in NPPESMarch 17, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Watauga Orthopaedics Plc — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Johnson City