Individual provider Active NPI

Matthew Joseph Dalton, L.M.T., B.S.

  • Massage Therapist
  • Fairmont, WV
National Provider Identifier
1487872321
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
19980191 Issued in WV
Practice address
2618 Fairmont Ave
Suite a
Fairmont, WV 26554-3418
Phone
(304) 368-9373
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 19980191 WV Primary

Addresses

Primary practice location

2618 Fairmont Ave
Suite a
Fairmont, WV 26554-3418

Mailing address

2618 Fairmont Ave
Suite a
Fairmont, WV 26554-3418
Phone (304) 368-9373

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
19980191WVMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487872321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 FAIRMONT AVE",
            "address_2": "SUITE A",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265543418",
            "telephone_number": "304-368-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 FAIRMONT AVE",
            "address_2": "SUITE A",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265543418",
            "telephone_number": "304-368-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "credential": "L.M.T., B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "19980191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.