Active NPI
Anna Katharine Dematteis, PT
- Physical Therapist
- Arden, NC
National Provider Identifier
1619251311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13405
- Practice address
- 3864 Sweeten Creek Rd
Arden, NC 28704-3136 - Phone
- (828) 681-0904
- NPI assigned
- Sep 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P13405 | NC | |
| Physical Therapist | 225100000X | 13405 | NC | Primary |
Addresses
Primary practice location
3864 Sweeten Creek Rd
Arden, NC 28704-3136
Mailing address
3864 Sweeten Creek Rd
Arden, NC 28704-3136
Other practice location 1
4687 Boylston Hwy
Mills River, NC 28759-6731
Phone (828) 890-0040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120605000038 | NC | Practitioner - Physical Therapist in Private Practice | 7012171085 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P13405 | NC | MD | Physical Therapist |
| 13405 | NC | MD | Occupational Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1619251311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3864 SWEETEN CREEK RD",
"city": "ARDEN",
"state": "NC",
"postal_code": "287043136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3864 SWEETEN CREEK RD",
"city": "ARDEN",
"state": "NC",
"postal_code": "287043136",
"telephone_number": "828-681-0904"
}
],
"practiceLocations": [
{
"address_1": "4687 Boylston Hwy",
"address_purpose": "LOCATION",
"city": "Mills River",
"state": "NC",
"postal_code": "287596731",
"country_code": "US",
"telephone_number": "828-890-0040",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEMATTEIS",
"first_name": "ANNA",
"middle_name": "KATHARINE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-29",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P13405",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "13405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.