Active NPI
Mathew Alan Tippett, PT
- Physical Therapist
- Altoona, PA
National Provider Identifier
1245301456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT017621
- Practice address
- 613 Valley View Blvd Ste 200
Altoona, PA 16602-6411 - Phone
- (814) 889-0310
- Fax
- (814) 889-0311
- NPI assigned
- Nov 10, 2006
- 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 | PT017621 | PA | Primary |
Addresses
Primary practice location
613 Valley View Blvd Ste 200
Altoona, PA 16602-6411
Mailing address
1527 Knob Rd
Portage, PA 15946-4415
Phone (814) 934-0582
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT017621 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584921600000",
"number": "1245301456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1527 KNOB RD",
"city": "PORTAGE",
"state": "PA",
"postal_code": "159464415",
"telephone_number": "814-934-0582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 VALLEY VIEW BLVD STE 200",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166026411",
"telephone_number": "814-889-0310",
"fax_number": "814-889-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPPETT",
"first_name": "MATHEW",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-10",
"last_updated": "2020-03-23",
"certification_date": "2020-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT017621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altoona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.