Matthew Dwayne Blick, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018295 Issued in MI

Practice address

331 E Wright Ave
Shepherd, MI 48883-8065

Phone

(989) 567-1300

Fax

(989) 567-1301

NPI assigned

Sep 1, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Physical Therapy Limited PartnershipGroup PAC ID 7618074220, 11 clinicians

Medical Rehabilitation Physicians PLCGroup PAC ID 5991778086, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Evergreen Physical Therapy Limited Partnership

  • Physical Therapist
  • Clare, MI
  • NPI 1295740637
  Medicare reassignment Care Compare group NPD
• Medical Rehabilitation Physicians PLC

  • Psychiatry Physician
  • Mt Pleasant, MI
  • NPI 1174698336
  Medicare reassignment Care Compare group
• Wright Avenue Rehab, PLLC

  • Physical Therapist
  • Shepherd, MI
  • NPI 1013520576
  NPD Authorized official
• Evergreen Physical Therapy Limited Partnership

  • Physical Therapist
  • Bay City, MI
  • NPI 1154647659
  NPD
• Evergreen Physical Therapy Limited Partnership

  • Physical Therapy Clinic/Center
  • Harrison, MI
  • NPI 1962515809

  Physical Therapist

  NPD

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1750809455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272",
            "telephone_number": "989-797-1400",
            "fax_number": "989-797-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E WRIGHT AVE",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488838065",
            "telephone_number": "989-567-1300",
            "fax_number": "989-567-1301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "158 N 1st St Ste D",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "MI",
            "postal_code": "486252520",
            "country_code": "US",
            "telephone_number": "989-539-4167",
            "fax_number": "989-539-4436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLICK",
        "first_name": "MATTHEW",
        "middle_name": "DWAYNE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-01",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Courageous Connections LLC

• Physical Therapist in Shepherd, MI
• Providers in Shepherd, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.