Active NPI
Matthew Caleb Beary, P.T.
- Physical Therapist
- Rockford, IL
National Provider Identifier
1215213475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070014163
- Practice address
- 1545 Temple Lane
Rockford, IL 61112 - Phone
- (815) 332-3272
- NPI assigned
- Nov 1, 2011
- 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 | 070014163 | IL | Primary |
Addresses
Primary practice location
1545 Temple Lane
Rockford, IL 61112
Mailing address
9172 Kilping Way
Machesney Park, IL 61115
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320105600000",
"number": "1215213475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9172 KILPING WAY",
"city": "MACHESNEY PARK",
"state": "IL",
"postal_code": "61115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 TEMPLE LANE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61112",
"telephone_number": "815-332-3272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARY",
"first_name": "MATTHEW",
"middle_name": "CALEB",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-01",
"last_updated": "2011-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070014163",
"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 Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.