Individual provider Active NPI

Ryan Mattes, OTR

  • Occupational Therapist
  • Littleton, CO
National Provider Identifier
1407574197
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0005822 Issued in CO
Practice address
5555 S Elati St
Littleton, CO 80120-1624
Phone
(630) 386-1306
NPI assigned
Aug 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0005822 CO Primary

Addresses

Primary practice location

5555 S Elati St
Littleton, CO 80120-1624

Mailing address

3075 W Radcliff Dr
Englewood, CO 80110-5337
Phone (630) 386-1306

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Cherrelyn

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

LicenseStateTypeSpecialty
0005822COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1407574197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 W RADCLIFF DR",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801105337",
            "telephone_number": "630-386-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 S ELATI ST",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801201624",
            "telephone_number": "630-386-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTES",
        "first_name": "RYAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0005822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cherrelyn",
            "affiliation": "N",
            "address_1": "5555 S Elati St",
            "city": "Littleton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801201624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.