Individual provider Active NPI

Sherry Wayman Matijevich, PT

  • Physical Therapist
  • Morristown, TN
National Provider Identifier
1255345997
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1188 Issued in TN
Practice address
1450 Pin Oak Dr
Morristown, TN 37814-1432
Phone
(423) 748-4800
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1188 TN Primary

Addresses

Primary practice location

1450 Pin Oak Dr
Morristown, TN 37814-1432

Mailing address

833 Lakewood Dr
Jefferson City, TN 37760-5130
Phone (423) 748-4800

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

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255345997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 LAKEWOOD DR",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377605130",
            "telephone_number": "423-748-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 PIN OAK DR",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378141432",
            "telephone_number": "423-748-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIJEVICH",
        "first_name": "SHERRY",
        "middle_name": "WAYMAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "1188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.