Active NPI
Matthew Harris, CPO
- Orthotic Fitter
- Laramie, WY
National Provider Identifier
1407444334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- CPO03586
- Practice address
- 1909 Vista Dr BLDG B
Laramie, WY 82070-5530 - Phone
- (307) 721-8024
- NPI assigned
- Jan 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | CPO03586 | WY | Primary |
Addresses
Primary practice location
1909 Vista Dr BLDG B
Laramie, WY 82070-5530
Mailing address
1909 Vista Dr BLDG B
Laramie, WY 82070-5530
Phone (307) 721-8024
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 |
|---|---|---|---|
| CPO03586 | WY | MD | Orthotic Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1407444334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 VISTA DR BLDG B",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705530",
"telephone_number": "307-721-8024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 VISTA DR BLDG B",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705530",
"telephone_number": "307-721-8024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "MATTHEW",
"credential": "CPO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-06",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "WY",
"license": "CPO03586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.