Matthew Blair, PTA
Individual provider Active NPI Physical Therapy Assistant · Silver City, NM
NPI 1699226506 · NPPES record last updated Dec 20, 2023
Key facts
- NPI
- 1699226506
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PT-2023-2389 (NM)
- Practice address
- 3514 N Fowler Ave
Silver City, NM 88061-7210 - Phone
- (575) 388-3127
- NPI assigned
- Oct 17, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06006588A | IN | MD | Physical Therapy Assistant |
| 10061 | MA | MD | Physical Therapy Assistant |
| PT-2023-2389 | NM | MD | Physical Therapy Assistant |
| 2561-19 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06006588A | IN | |
| Physical Therapy Assistant | 225200000X | 2561-19 | WI | |
| Physical Therapy Assistant | 225200000X | 10061 | MA | |
| Physical Therapy Assistant | 225200000X | 2349 | CT | |
| Physical Therapy Assistant | 225200000X | PT-2023-2389 | NM | Yes |
Addresses
Primary practice location
3514 N Fowler Ave
Silver City, NM 88061-7210
Mailing address
PO Box 427
Nora, IL 61059-0427
Phone (608) 228-1721
Other providers in Silver City, NM
- John Berry
- Pratiksha Deenesh Bhaleeya
- Bhisit Bhothinard
- Margaret Billings
- Peter Birkholz
- Karen S. Blisard
- Autumn Blume
- Debbra Bonney
- Caytlyn Foy Bonura
- Angelica Boone
All providers in Silver City, NM · Physical Therapy Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.