Matthew M Shiomichi, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305213888 Issued in VA

Practice address

161 Wadsworth Dr
North Chesterfield, VA 23236-4500

Phone

(804) 484-3700

Fax

(804) 320-6462

NPI assigned

Jul 24, 2012

Last updated

Nov 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Ear Nose and Throat Associates PCGroup PAC ID 6901794999, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Virginia Ear Nose & Throat Associates PC

  • Otolaryngology Physician
  • North Chesterfield, VA
  • NPI 1356325757
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1093060311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36007",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232358000",
            "telephone_number": "804-484-3700",
            "fax_number": "804-320-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 WADSWORTH DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364500",
            "telephone_number": "804-484-3700",
            "fax_number": "804-320-6462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3540 Mayland Ct",
            "address_purpose": "LOCATION",
            "city": "Henrico",
            "state": "VA",
            "postal_code": "23233",
            "country_code": "US",
            "telephone_number": "804-484-3700",
            "fax_number": "804-320-6462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIOMICHI",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24103",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213888",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "24103",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheridan Children's Healthcare Services of Virginia, Inc
• Sarah Ward Sherman, RN. ACNP-BC
• Rachel E. J Shields, PA-C
• Jaime Nichole Shill, LPC
• Sojung Shim
• Kenneth Marvin Shirley, LPC
• Shore Home Care Agency Inc
• Shore Home Care Agency, LLC
• Ashley M. Shoultz, FNP
• Abigail Shoun, BCBA

• Physical Therapist in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.