Individual provider Active NPI

Matthew Cevin Carr

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1043989304
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
22745 Issued in CA
Practice address
8515 Costa Verde Blvd
San Diego, CA 92122-1130
Phone
(888) 674-4036
NPI assigned
Sep 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 22745 CA Primary

Addresses

Primary practice location

8515 Costa Verde Blvd
San Diego, CA 92122-1130

Mailing address

13754 Mango Dr Unit 117
Del Mar, CA 92014-3433
Phone (435) 513-0871

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

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1043989304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13754 MANGO DR UNIT 117",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143433",
            "telephone_number": "435-513-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 COSTA VERDE BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221130",
            "telephone_number": "888-674-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "MATTHEW",
        "middle_name": "CEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "22745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.