Individual provider Active NPI

Matthew Gregory Williams, OT

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1215364690
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
5201 Mid America PLZ Ste 2600
Saint Louis, MO 63129-0002
Phone
(314) 487-7000
Fax
(314) 487-7001
NPI assigned
Oct 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

5201 Mid America PLZ Ste 2600
Saint Louis, MO 63129-0002

Mailing address

600 Oakmont LN Ste 600
Westmont, IL 60559-5548
Phone (630) 575-1980

Other practice location 1

1 Stevenson Dr
Lincolnshire, IL 60069-2824
Phone (847) 415-4238

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190402002134 MO Practitioner - Occupational Therapist in Private Practice 9739420647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axes Physical Therapy LLCGroup PAC ID 3375840028, 112 clinicians

Practice addresses (Care Compare)

7483 Mexico Rd
Saint Peters, MO 63376-1304
Phone (636) 206-3654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC CurrentSince Jan 4, 2021 Accepting new patients
Axes Physical Therapy, LLC CurrentSince Jan 4, 2021 Accepting new patients
Athletico LTD Occupational Therapist Past Accepting new patients

Locations

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

7483 Mexico Rd
Saint Peters, MO 63376
Phone (636) 206-3654

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

Interoperability endpoints

  • Direct secure messaging: matthew.williams.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 4

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": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1215364690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 MID AMERICA PLZ STE 2600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290002",
            "telephone_number": "314-487-7000",
            "fax_number": "314-487-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Stevenson Dr",
            "address_purpose": "LOCATION",
            "city": "Lincolnshire",
            "state": "IL",
            "postal_code": "600692824",
            "country_code": "US",
            "telephone_number": "847-415-4238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MATTHEW",
        "middle_name": "GREGORY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.