Individual provider Active NPI

Jacqueline A. Mathwich, P.T.

  • Physical Therapist
  • Chestertown, MD
National Provider Identifier
1437205945
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15051 Issued in MD
Practice address
818 High St
Suite 1
Chestertown, MD 21620-1152
Phone
(410) 778-6565
Fax
(410) 778-6536
NPI assigned
Jan 26, 2007
Last updated
Feb 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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 15051 MD Primary

Addresses

Primary practice location

818 High St
Suite 1
Chestertown, MD 21620-1152

Mailing address

818 High St
Suite 1
Chestertown, MD 21620-1152
Phone (410) 778-6565

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
15051MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chestertown Physical Therapy Services, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1437205945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 HIGH ST",
            "address_2": "SUITE 1",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201152",
            "telephone_number": "410-778-6565",
            "fax_number": "410-778-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 HIGH ST",
            "address_2": "SUITE 1",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201152",
            "telephone_number": "410-778-6565",
            "fax_number": "410-778-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHWICH",
        "first_name": "JACQUELINE",
        "middle_name": "A.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "15051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.