Individual provider Active NPI

Matthew Campbell

  • Occupational Therapist
  • Dayton, OH
National Provider Identifier
1588056246
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.008402 Issued in OH
Practice address
5916 Yarmouth Dr
Dayton, OH 45459-1450
Phone
(937) 369-7573
NPI assigned
Mar 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT.008402 OH Primary

Addresses

Primary practice location

5916 Yarmouth Dr
Dayton, OH 45459-1450

Mailing address

5916 Yarmouth Dr
Dayton, OH 45459-1450
Phone (937) 369-7573

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT.008402OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1588056246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 YARMOUTH DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454591450",
            "telephone_number": "937-369-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 YARMOUTH DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454591450",
            "telephone_number": "937-369-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-04",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT.008402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; 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.