Active NPI
Michelle Mathewson, PT
- Physical Therapist
- Prineville, OR
National Provider Identifier
1750706123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 04170
- Practice address
- 1201 NE Elm St
Prineville, OR 97754-1206 - Phone
- (541) 447-6254
- NPI assigned
- Feb 21, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 04170 | OR | Primary |
Addresses
Primary practice location
1201 NE Elm St
Prineville, OR 97754-1206
Mailing address
PO Box 7287
Bend, OR 97708-7287
Phone (541) 447-6254
Other names 1
- Shelley Mathewson
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 |
|---|---|---|---|
| 04170 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1750706123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7287",
"city": "BEND",
"state": "OR",
"postal_code": "977087287",
"telephone_number": "541-447-6254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 NE ELM ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541206",
"telephone_number": "541-447-6254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWSON",
"first_name": "MICHELLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-21",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "04170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEY",
"last_name": "MATHEWSON",
"credential": "PT",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.