Active NPI
Matthew Corey Matlock, PTA
- Physical Therapy Assistant
- Davie, FL
National Provider Identifier
1013994417
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Dec 18, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA18860
- Practice address
- 4691 S University Dr
Davie, FL 33328-3817 - Phone
- (954) 434-7246
- Fax
- (954) 434-8104
- NPI assigned
- Dec 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA18860 | FL | Primary |
Addresses
Primary practice location
4691 S University Dr
Davie, FL 33328-3817
Mailing address
4691 S University Dr
Davie, FL 33328-3817
Phone (954) 434-7246
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA18860 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1013994417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4691 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283817",
"telephone_number": "954-434-7246",
"fax_number": "954-434-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4691 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283817",
"telephone_number": "954-434-7246",
"fax_number": "954-434-8104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOCK",
"first_name": "MATTHEW",
"middle_name": "COREY",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA18860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.