Matthew Ryan Zachman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06003588A Issued in IN

Practice address

12523 Auburn Rd
Fort Wayne, IN 46845-8797

Phone

(260) 204-0546

Fax

(260) 204-0547

NPI assigned

Feb 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1477144236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1884 CYMBELINE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189265",
            "telephone_number": "260-443-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12523 AUBURN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458797",
            "telephone_number": "260-204-0546",
            "fax_number": "260-204-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHMAN",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003588A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mukhabbat Yusupova, MA
• Ywca Northeast Indiana Inc
• Milan Za, MD
• Judy L. Zacher, M.D.
• Kathryn Zachman-Pavell, O.D.
• Thomas Robert Zachman, O.D.
• Erica L Zachrich, PT
• Annette Lillian Zacur, APRN
• Carina Amira Zahdeh, MD
• Jacquelyne Zahner

• Physical Therapy Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.

Verify at the official NPI Registry.