Individual provider Active NPI

Matthew R Dailey, PT

  • Physical Therapist
  • Port St Joe, FL
National Provider Identifier
1659615813
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28304 Issued in FL
Practice address
106 Sailors Cove Dr
Port St Joe, FL 32456-1890
Phone
(850) 544-2197
Fax
(850) 743-4088
NPI assigned
Nov 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070018750 IL
Physical Therapist 225100000X PT28304 FL Primary

Addresses

Primary practice location

106 Sailors Cove Dr
Port St Joe, FL 32456-1890

Mailing address

106 Sailors Cove Dr
Port St Joe, FL 32456-1890
Phone (850) 544-2197

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250213001657 FL Practitioner - Physical Therapist in Private Practice 1456591023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dailey Therapy, LLCGroup PAC ID 0648700146, 2 clinicians

Practice addresses (Care Compare)

106 Sailors Cove Dr
Suite B
Port Saint Joe, FL 32456-1890
Phone (850) 544-2197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28304FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dailey Therapy, LLC Physical Therapist CurrentSince Nov 7, 2024 Accepting new patients
Premier Rehab Management, LLC Physical Therapist Past Accepting new patients

Locations

106 Sailors Cove Dr
#B
Port Saint Joe, FL 32456
Phone (850) 544-2197

Organizations & group practices 2

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": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1659615813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SAILORS COVE DR",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324561890",
            "telephone_number": "850-544-2197",
            "fax_number": "850-743-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SAILORS COVE DR",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324561890",
            "telephone_number": "850-544-2197",
            "fax_number": "850-743-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAILEY",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018750",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Joe, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.