Active NPI
Matthew Tallman, OTR/L
- Occupational Therapist
- Johnson City, TN
National Provider Identifier
1740529395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4700
- Practice address
- 302 Wesley St
Suite 8
Johnson City, TN 37601-1740 - Phone
- (423) 282-1700
- NPI assigned
- Feb 1, 2013
- Last updated
- Feb 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4700 | TN | Primary |
Addresses
Primary practice location
302 Wesley St
Suite 8
Johnson City, TN 37601-1740
Mailing address
3379 Rock Hold Rd
Bluff City, TN 37618-3501
Phone (423) 366-1994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4700 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1740529395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3379 ROCK HOLD RD",
"city": "BLUFF CITY",
"state": "TN",
"postal_code": "376183501",
"telephone_number": "423-366-1994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 WESLEY ST",
"address_2": "SUITE 8",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376011740",
"telephone_number": "423-282-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLMAN",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-01",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "4700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.