Mary Mattis, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10091 Issued in SC

Practice address

943 Pine Log Rd
Aiken, SC 29803-7330

Phone

(803) 649-9797

NPI assigned

Sep 1, 2009

Last updated

Apr 9, 2020By the provider in NPPES

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

Other names 1

• Mary Libby Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Group practices

South Aiken Physical Therapy LLCGroup PAC ID 3678745320, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Aiken Physical Therapy, LLC

  • Physical Therapist
  • Aiken, SC
  • NPI 1558653196
  Medicare reassignment Care Compare group NPD
• Mary Mattis P T Inc

  dba Fit2MoveWell

  • Physical Therapy Clinic/Center
  • Aiken, SC
  • NPI 1518430339
  NPD Authorized official
• Progressive Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Ormond Beach, FL
  • NPI 1013088962
  NPD (past)

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1780817148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 GREENWICH DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298036541",
            "telephone_number": "386-846-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 PINE LOG RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037330",
            "telephone_number": "803-649-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Venture Dr",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "South Daytona",
            "state": "FL",
            "postal_code": "321193478",
            "country_code": "US",
            "telephone_number": "386-763-0084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2330 S Nova Rd Bldg 2",
            "address_purpose": "LOCATION",
            "city": "South Daytona",
            "state": "FL",
            "postal_code": "321192514",
            "country_code": "US",
            "telephone_number": "386-846-7062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTIS",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14465",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LIBBY",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Calen Briana Matos, BSN, RN, CPNP-PC
• Marianne Matos
• Betsy Ginger Matthews, MSP, CCC-SLP
• Bonnie Matthews
• Christine M Matthews, MA, CCC/SLP
• Cassie Mattox
• Kate Barrett Mayes, MD
• Michele Burns Maynard, PTA
• Donna K. Mayo, PA-C
• Keisha Mays, MPH, MCHES, NBC-HWC

• Physical Therapist in Aiken, SC
• Providers in Aiken, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.