Active NPI
Matthew Crysel
- Physical Therapy Assistant
- Dickson, TN
National Provider Identifier
1366938003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA0000006710
- Practice address
- 812 N Charlotte St
Dickson, TN 37055-1009 - Phone
- (615) 446-8046
- NPI assigned
- Jul 5, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA0000006710 | TN | Primary |
Addresses
Primary practice location
812 N Charlotte St
Dickson, TN 37055-1009
Mailing address
5342 Bales Rd
Cunningham, TN 37052-4715
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA0000006710 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530748800000",
"number": "1366938003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5342 BALES RD",
"city": "CUNNINGHAM",
"state": "TN",
"postal_code": "370524715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 N CHARLOTTE ST",
"city": "DICKSON",
"state": "TN",
"postal_code": "370551009",
"telephone_number": "615-446-8046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRYSEL",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-05",
"last_updated": "2018-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "PTA0000006710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dickson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.