Individual provider Active NPI

Matthew Sharon, PTA

  • Physical Therapy Assistant
  • Knoxville, TN
National Provider Identifier
1174097414
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4951 Issued in TN
Practice address
5321 Beverly Park Cir
Knoxville, TN 37918-9253
Phone
(865) 661-7243
NPI assigned
Jan 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 4951 TN Primary

Addresses

Primary practice location

5321 Beverly Park Cir
Knoxville, TN 37918-9253

Mailing address

637 Pennsylvania Ave
Oak Ridge, TN 37830-5170
Phone (865) 661-7243

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

LicenseStateTypeSpecialty
4951TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1174097414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 PENNSYLVANIA AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305170",
            "telephone_number": "865-661-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5321 BEVERLY PARK CIR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379189253",
            "telephone_number": "865-661-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARON",
        "first_name": "MATTHEW",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "4951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.

Verify at the official NPI Registry.