Individual provider Active NPI

Matthew B Dodson, OTD

  • Occupational Therapist
  • Fort Collins, CO
National Provider Identifier
1205030376
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0004071 Issued in CO
Practice address
2850 McClelland Dr Ste 3000I
Fort Collins, CO 80525-5206
Phone
(409) 739-2607
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0004071 CO Primary

Addresses

Primary practice location

2850 McClelland Dr Ste 3000I
Fort Collins, CO 80525-5206

Mailing address

2850 McClelland Dr Ste 3000I
Fort Collins, CO 80525-5206
Phone (409) 739-2607

Other identifiers 1

IdentifierTypeStateIssuer
1205030376OtherNPI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0004071COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Braintrust Services Occupational Therapist CurrentSince Sep 27, 2020 Accepting new patients

Locations

2850 McClelland Dr
Ste 3000I
Fort Collins, CO 80525
Phone (409) 739-2607

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1205030376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 MCCLELLAND DR STE 3000I",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255206",
            "telephone_number": "409-739-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 MCCLELLAND DR STE 3000I",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255206",
            "telephone_number": "409-739-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0004071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205030376",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.