Individual provider Active NPI

Mathew Tran Lim, PT, DPT

  • Physical Therapist
  • Morrilton, AR
National Provider Identifier
1295402444
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5034 Issued in AR
Practice address
100 Walmart Dr Ste 5
Morrilton, AR 72110-4525
Phone
(501) 477-2202
Fax
(501) 421-0543
NPI assigned
Aug 25, 2021
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 5034 AR Primary

Addresses

Primary practice location

100 Walmart Dr Ste 5
Morrilton, AR 72110-4525

Mailing address

100 Walmart Dr Ste 5
Morrilton, AR 72110-4525
Phone (501) 477-2202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119000949 AR Practitioner - Physical Therapist in Private Practice 8123499787 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5034ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vida Physical Therapy PLLC Physical Therapist Current Accepting new patients
KNH LLC Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients

Locations

130 Houston Ave
Ste C
Perryville, AR 72126
Phone (501) 889-1900

236 Houston Ave
Perryville, AR 72126
Phone (501) 889-1900

Organizations & group practices 2

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1295402444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALMART DR STE 5",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721104525",
            "telephone_number": "501-477-2202",
            "fax_number": "501-421-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WALMART DR STE 5",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721104525",
            "telephone_number": "501-477-2202",
            "fax_number": "501-421-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "MATHEW",
        "middle_name": "TRAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrilton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.