Individual provider Active NPI

Matt Sheaff, PTA

  • Physical Therapy Assistant
  • Lebanon, NH
National Provider Identifier
1003241423
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1133 Issued in NH
Practice address
24 Old Etna Rd
Lebanon, NH 03766-1937
Phone
(603) 986-0120
NPI assigned
Sep 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1133 NH Primary

Addresses

Primary practice location

24 Old Etna Rd
Lebanon, NH 03766-1937

Mailing address

20 Wolf Rd
Apartment B-13
Lebanon, NH 03766-1903
Phone (603) 986-0120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1133NHMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1003241423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WOLF RD",
            "address_2": "APARTMENT B-13",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661903",
            "telephone_number": "603-986-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 OLD ETNA RD",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661937",
            "telephone_number": "603-986-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAFF",
        "first_name": "MATT",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "1133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.