Active NPI
Matthew Tyler McKeown, DPT
- Physical Therapist
- Monticello, AR
National Provider Identifier
1043848674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4691
- Practice address
- 778 Scogin Dr
Monticello, AR 71655-5729 - Phone
- (870) 460-3540
- Fax
- (870) 460-4860
- NPI assigned
- Mar 30, 2020
- 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 Therapist | 225100000X | PT4691 | AR | Primary |
Addresses
Primary practice location
778 Scogin Dr
Monticello, AR 71655-5729
Mailing address
679 Rock Springs Rd
Wilmar, AR 71675-7112
Phone (870) 224-2675
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT4691 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1043848674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "679 ROCK SPRINGS RD",
"city": "WILMAR",
"state": "AR",
"postal_code": "716757112",
"telephone_number": "870-224-2675",
"fax_number": "870-460-4860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "778 SCOGIN DR",
"city": "MONTICELLO",
"state": "AR",
"postal_code": "716555729",
"telephone_number": "870-460-3540",
"fax_number": "870-460-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKEOWN",
"first_name": "MATTHEW",
"middle_name": "TYLER",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-30",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT4691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.