Alyssa Matthews, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-2893 Issued in ID

Practice address

6640 Kaniksu St
Bonners Ferry, ID 83805-7532

Phone

(208) 267-3141

NPI assigned

Apr 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1720660160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 NICHOLS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057013275",
            "telephone_number": "802-775-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 KANIKSU ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057532",
            "telephone_number": "208-267-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Nichols St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057013275",
            "country_code": "US",
            "telephone_number": "802-775-2941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "ALYSSA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VT",
            "license": "072.0134180",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-2893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth M Mackey, ARNP
• Nicole Diana Madill-Klupenger, LCPC 6404
• Main Street Medical LLC
• Mark R. Barker, O.D.P.C.
• Jessica Martin, RN, BSN
• Wendolyn E McClintock, R.D., L.D.
• Jeffrey McDowell, LCPC
• David Lynn McIntosh, DDS
• Ashlie Mead
• Medicine Man Bonners Ferry Pharmacy LLC

• Occupational Therapist in Bonners Ferry, ID
• Providers in Bonners Ferry, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.