Organization Active NPI

Greenwood Osteopractic Physical Therapy & Educational Services PLLC

  • Physical Therapy Clinic/Center
  • Rockford, IL
National Provider Identifier
1154283174
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
GREENWOOD OSTEOPRACTIC PHYSICAL THERAPY & EDUCATIONAL SERVICES PLLC
Practice address
3490 Colony Bay Dr
Rockford, IL 61109-2560
Phone
(815) 691-2708
NPI assigned
Nov 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Matthew Wayne GreenwoodNPI 1437161759
Title
Physical Therapist
Phone
(815) 222-3629

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3490 Colony Bay Dr
Rockford, IL 61109-2560

Mailing address

3490 Colony Bay Dr
Rockford, IL 61109-2560
Phone (815) 691-2708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260514003756 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678042082 Receives reassigned benefits from 1 practitioner
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

3490 Colony Bay Dr
Rockford, IL 61109
Phone (779) 368-0012

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1154283174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 COLONY BAY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092560",
            "telephone_number": "815-691-2708",
            "fax_number": "815-595-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 COLONY BAY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092560",
            "telephone_number": "815-691-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD OSTEOPRACTIC PHYSICAL THERAPY & EDUCATIONAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-28",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "GREENWOOD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "815-222-3629"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.