Active NPI
Scott M Mathewson, OTR/L
- Occupational Therapist
- Fort Wayne, IN
National Provider Identifier
1336779347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31006240A
- Practice address
- 300 E Washington Blvd
Fort Wayne, IN 46802-3124 - Phone
- (260) 422-5511
- NPI assigned
- Jan 17, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31006240A | IN | Primary |
Addresses
Primary practice location
300 E Washington Blvd
Fort Wayne, IN 46802-3124
Mailing address
2309 Foxboro Dr
Fort Wayne, IN 46818-1886
Phone (219) 793-4720
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 |
|---|---|---|---|
| 31006240A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1336779347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 FOXBORO DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468181886",
"telephone_number": "219-793-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E WASHINGTON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468023124",
"telephone_number": "260-422-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWSON",
"first_name": "SCOTT",
"middle_name": "M",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-17",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31006240A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.