Individual provider Active NPI

Matthew Oliver

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1457805558
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1278096 Issued in TX
Practice address
12727 Kimberley LN Ste 104
Houston, TX 77024-4060
Phone
(713) 365-9338
NPI assigned
Aug 8, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 1278096 TX Primary

Addresses

Primary practice location

12727 Kimberley LN Ste 104
Houston, TX 77024-4060

Mailing address

2600 Gramercy St Apt 312
Houston, TX 77030-3174
Phone (541) 941-0683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190524000155 CO Practitioner - Physical Therapist in Private Practice 7810285996 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1278096TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phenix Therapies, LLC Physical Therapist CurrentSince Apr 26, 2019 Accepting new patients
Action Therapy Centers Limited Past Accepting new patients

Locations

1625 Medical Center Pt
Ste 180
Colorado Springs, CO 80907
Phone (719) 440-1961

Organizations & group practices 2

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457805558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 GRAMERCY ST APT 312",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303174",
            "telephone_number": "541-941-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12727 KIMBERLEY LN STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770244060",
            "telephone_number": "713-365-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1278096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.