Matt Defrancisco, DPT

Key facts

NPI

1699320200

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

096541 (IA)

Practice address

630 S Main St
Water Valley, MS 38965-3468

Phone

(662) 473-1411

NPI assigned

Aug 9, 2019

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)

Yes

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 9, 2019.

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1699320200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 WEYBRIDGE",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501318721",
            "telephone_number": "515-867-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S MAIN ST",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389653468",
            "telephone_number": "662-473-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFRANCISCO",
        "first_name": "MATT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "096541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Water Valley, MS · Physical Therapist in Mississippi