Individual provider Active NPI

Matthew Austin Green, MPT

  • Physical Therapist
  • Fenton, MO
National Provider Identifier
1245951649
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11943 Issued in SC
Practice address
1011 Bowles Ave Ste 150
Fenton, MO 63026-2384
Phone
(636) 343-9555
Fax
(636) 343-9556
NPI assigned
Sep 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11943 SC Primary

Addresses

Primary practice location

1011 Bowles Ave Ste 150
Fenton, MO 63026-2384

Mailing address

2636 Accomac St
Saint Louis, MO 63104-2218
Phone (314) 607-7817

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920003114 SC Practitioner - Physical Therapist in Private Practice 4082671953 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians
Benchmark Healthcare Services LLCGroup PAC ID 3779726468, 136 clinicians

Practice addresses (Care Compare)

370 E 5TH N St
Summerville, SC 29483-6826
Phone (843) 737-6913

7955 N Kings Hwy
Suite 330
Myrtle Beach, SC 29572-3056
Phone (843) 945-1815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004004898MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Aug 31, 2025 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Aug 31, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Aug 31, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Aug 31, 2025 Accepting new patients
SSM Select Rehab St Louis LLC PastSince Sep 11, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

135 Blythewood Rd
#J
Blythewood, SC 29016
Phone (803) 851-1037

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

7955 N Kings Hwy
Ste 330
Myrtle Beach, SC 29572
Phone (843) 945-1815

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

370 E 5th North St
Summerville, SC 29483
Phone (843) 737-6913

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1245951649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 ACCOMAC ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042218",
            "telephone_number": "314-607-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE 150",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262384",
            "telephone_number": "636-343-9555",
            "fax_number": "636-343-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MATTHEW",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.