Matthew Scott Weigel, PT
Individual provider Active NPI Physical Therapist · Spearfish, SD
NPI 1104025907 · NPPES record last updated Nov 8, 2012
Key facts
- NPI
- 1104025907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1629 (SD)
- Practice address
- 520 N Canyon St
Spearfish, SD 57783-2320 - Phone
- (605) 642-7996
- Fax
- (605) 642-5955
- NPI assigned
- Jul 12, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5558 | OR | MD | Chiropractor |
| 1629 | SD | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matson Therapy, LLC | Physical Therapist | Past |
Accepting new patients |
| Peak Motion Physical Therapy, Inc | Physical Therapist | Past | Accepting new patients |
| Black Hills Physical Therapy, Inc. | Physical Therapist | Past |
Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1629 | SD | Yes |
Addresses
Primary practice location
520 N Canyon St
Spearfish, SD 57783-2320
Mailing address
520 N Canyon St
Spearfish, SD 57783-2320
Phone (605) 642-7996
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104025907 | Medicaid | SD | |
| 1104025907 | Other | SD | WELLMARK BC/BS |
Other providers in Spearfish, SD
- Brianna Warnemunde
- Wcos, PC
- Weber Chiropractic
- Michael D Weber
- Ashleigh Weibel
- Mason Wellskopf
- Douglas John Wessel
- West River Transit Authority, Inc.
- White Spruce Wellness PLLC
- Christian Whitesell
All providers in Spearfish, SD · Physical Therapist in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.