Individual provider Active NPI

Matthew Fletcher

  • Physical Therapist
  • Prescott Valley, AZ
National Provider Identifier
1487296042
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-30922 Issued in AZ
Practice address
6421 E Marley Ave
Prescott Valley, AZ 86314-3871
Phone
(602) 614-2801
NPI assigned
Oct 15, 2019
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 LPT-30922 AZ Primary

Addresses

Primary practice location

6421 E Marley Ave
Prescott Valley, AZ 86314-3871

Mailing address

6421 E Marley Ave
Prescott Valley, AZ 86314-3871
Phone (602) 614-2801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191230002193 AZ Practitioner - Physical Therapist in Private Practice 3274967104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6421 E Marley Ave
Prescott Valley, AZ 86314-3871
Phone (602) 614-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Jul 18, 2022 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

20320 N John Wayne Pkwy
Ste 120
Maricopa, AZ 85139
Phone (520) 635-2260

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

790 Remington Blvd
Bolingbrook, IL 60440

Organizations & group practices 3

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1487296042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 E MARLEY AVE",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863143871",
            "telephone_number": "602-614-2801",
            "fax_number": "844-747-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 E MARLEY AVE",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863143871",
            "telephone_number": "602-614-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-15",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-30922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.