Individual provider Active NPI

Matthew Minniear

  • Occupational Therapy Assistant
  • Beavercreek, OH
National Provider Identifier
1235036633
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA009049 Issued in OH
Practice address
4085 Shakertown Rd
Beavercreek, OH 45430-1034
Phone
(937) 429-7567
NPI assigned
Oct 20, 2026
Last updated
Oct 20, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA009049 OH Primary

Addresses

Primary practice location

4085 Shakertown Rd
Beavercreek, OH 45430-1034

Mailing address

1318 Jennings CT
Mason, OH 45040-1116

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

NPI Registry JSON

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

{
    "created_epoch": "1792454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792454400000",
    "number": "1235036633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 JENNINGS CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 SHAKERTOWN RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301034",
            "telephone_number": "937-429-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIEAR",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-10-20",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA009049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2026; 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.