Active NPI
Matthew Davis, P.T.
- Physical Therapist
- Salem, OR
National Provider Identifier
1770908378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05859
- Practice address
- 1955 Dallas Hwy NW
Ste 1200
Salem, OR 97304-4466 - Phone
- (503) 362-4101
- NPI assigned
- Feb 19, 2014
- Sex
- Male
- 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 | 05859 | OR | Primary |
Addresses
Primary practice location
1955 Dallas Hwy NW
Ste 1200
Salem, OR 97304-4466
Mailing address
377 NW Jasper St
Dallas Retirment Village, Large Conference Room
Dallas, OR 97338-1279
Phone (503) 623-1844
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 |
|---|---|---|---|
| 05859 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392768000000",
"number": "1770908378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 NW JASPER ST",
"address_2": "DALLAS RETIRMENT VILLAGE, LARGE CONFERENCE ROOM",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381279",
"telephone_number": "503-623-1844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 DALLAS HWY NW",
"address_2": "STE 1200",
"city": "SALEM",
"state": "OR",
"postal_code": "973044466",
"telephone_number": "503-362-4101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MATTHEW",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-19",
"last_updated": "2014-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "05859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.