Individual provider Active NPI

Matthew Dean Sells, DPT

  • Physical Therapist
  • Vienna, WV
National Provider Identifier
1720368483
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002965 Issued in WV
Practice address
800 Grand Central Mall
Suite 1
Vienna, WV 26105-4100
Phone
(304) 865-6777
Fax
(304) 865-6780
NPI assigned
Aug 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT002965 WV Primary

Addresses

Primary practice location

800 Grand Central Mall
Suite 1
Vienna, WV 26105-4100

Mailing address

415 36TH St
Suite 100
Parkersburg, WV 26101-1005
Phone (304) 917-3660

Other identifiers 2

IdentifierTypeStateIssuer
0061221MedicaidOH
3810022896MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000205 WV Practitioner - Physical Therapist in Private Practice 8921275579 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

800 Grand Central Mall
Suite 4
Vienna, WV 26105-4100
Phone (304) 485-3300

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT002965WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain River Physical Therapy LLC Physical Therapist CurrentSince Nov 15, 2011 Accepting new patients
Mountain River Physical Therapy Specialists LLC Physical Therapist CurrentSince Nov 16, 2020 Accepting new patients
Mountain River Physical Therapy Specialists LLC Physical Therapist CurrentSince Nov 16, 2020 Accepting new patients
Camden-Clark Physician Corporation CurrentSince Apr 1, 2024 Accepting new patients
Mountain River Physical Therapy, LLC CurrentSince Nov 15, 2011 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

1212 Garfield Ave
Ste 200
Parkersburg, WV 26101
Phone (304) 865-2778

415 36th St
Ste 100
Parkersburg, WV 26101
Phone (304) 917-3660

800 Grand Central Mall
Ste 4
Vienna, WV 26105
Phone (304) 485-3300

800 Grand Central Mall
Ste 1
Vienna, WV 26105
Phone (304) 424-4419

Organizations & group practices 6

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": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1720368483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST",
            "address_2": "SUITE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 1",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-865-6777",
            "fax_number": "304-865-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLS",
        "first_name": "MATTHEW",
        "middle_name": "DEAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT002965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061221",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022896",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.