Active NPI
Matthew James Osborne, PT
- Physical Therapist
- Shawano, WI
National Provider Identifier
1164084760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14680
- Practice address
- 100 County Road B
Shawano, WI 54166-7072 - Phone
- (715) 526-7370
- Fax
- (999) 999-9999
- NPI assigned
- Jul 3, 2019
- 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 | 14680 | WI | Primary |
Addresses
Primary practice location
100 County Road B
Shawano, WI 54166-7072
Mailing address
122 E College Ave
Appleton, WI 54911-5794
Phone (920) 996-3264
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 |
|---|---|---|---|
| 14680 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1164084760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 E COLLEGE AVE",
"city": "APPLETON",
"state": "WI",
"postal_code": "549115794",
"telephone_number": "920-996-3264",
"fax_number": "920-830-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COUNTY ROAD B",
"city": "SHAWANO",
"state": "WI",
"postal_code": "541667072",
"telephone_number": "715-526-7370",
"fax_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSBORNE",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-03",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawano, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.