Individual provider Active NPI

Matt Taylor, PT, DPT, CWS, WCS

  • Physical Therapist
  • Springfield, MO
National Provider Identifier
1013380740
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2014039476 Issued in MO
Practice address
2017 W Woodland St
Springfield, MO 65807-5913
Phone
(417) 889-4800
Fax
(417) 889-0980
NPI assigned
Nov 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2014039476 MO Primary

Addresses

Primary practice location

2017 W Woodland St
Springfield, MO 65807-5913

Mailing address

2017 W Woodland St
Springfield, MO 65807-5913
Phone (417) 889-4800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014039476MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1013380740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W WOODLAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075913",
            "telephone_number": "417-889-4800",
            "fax_number": "417-889-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W WOODLAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075913",
            "telephone_number": "417-889-4800",
            "fax_number": "417-889-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MATT",
        "credential": "PT, DPT, CWS, WCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2014039476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.