NPIMap

Organization Active NPI

Mat-Su Pediatric Physical Therapy LLC

  • Physical Therapist
  • Wasilla, AK
National Provider Identifier
1255040150
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAT-SU PEDIATRIC PHYSICAL THERAPY LLC
Practice address
2911 W Stonebridge Dr
Wasilla, AK 99654-9446
Phone
(775) 721-5370
NPI assigned
Nov 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Authorized official

Name
Abigail Ogilbee, DPTNPI 1457756934
Title
Owner, Physical Therapist
Phone
(775) 721-5370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2911 W Stonebridge Dr
Wasilla, AK 99654-9446

Mailing address

2911 W Stonebridge Dr
Wasilla, AK 99654-9446

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1255040150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 W STONEBRIDGE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996549446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 W STONEBRIDGE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996549446",
            "telephone_number": "775-721-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT-SU PEDIATRIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "OGILBEE",
        "authorized_official_first_name": "ABIGAIL",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "775-721-5370",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.