Matthew Gardner, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTT.200718 Issued in LA

Practice address

105 Blanchard St
West Monroe, LA 71291-7369

Phone

(318) 398-9940

NPI assigned

May 24, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Parish Therapy Center, LLCGroup PAC ID 8022048867, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jackson Parish Therapy Center LLC

  dba Fyzical Therapy & Balance Centers

  • Physical Therapist
  • Ruston, LA
  • NPI 1891794491

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jesse L Wied PT Physical Therapy Clinic Inc

  dba Wied Physical Therapy

  • Physical Therapist
  • Monroe, LA
  • NPI 1538101902

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1689366973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DARBONNE VIEW DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712914714",
            "telephone_number": "318-267-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BLANCHARD ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712917369",
            "telephone_number": "318-398-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MATTHEW",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "OTT.200718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G. B. Cooley Hospital Service District
• Charles Alfred Gagnon, ED. D., LPC-A
• Crystal Nicole Gallagher
• David Gann, DOCTOR OF PHARMACY
• Robert Luis Garcia, MD
• Gastrointestinal Consultants, Inc
• Svetlana Gavrilova, MED., RD, LDN, CDCES
• Holly Gay
• Ellen Ruth Gentile, APRN
• Carrie G Genusa, FNP

• Occupational Therapist in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.