NPIMap

Individual provider Active NPI

Matthew Phillips, CP

  • Prosthetist
  • Mooresville, NC
National Provider Identifier
1801564547
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
45PR00004000 Issued in NJ
Practice address
123 Professional Park Dr Ste 100
Mooresville, NC 28117-5516
Phone
(704) 999-8257
Fax
(704) 799-9826
NPI assigned
Aug 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X
Prosthetist 224P00000X 45PR00004000 NJ Primary

Addresses

Primary practice location

123 Professional Park Dr Ste 100
Mooresville, NC 28117-5516

Mailing address

123 Professional Park Dr Ste 100
Mooresville, NC 28117-5516
Phone (704) 799-9825

Other practice location 1

744 Hartness Rd
Statesville, NC 28677-3425
Phone (704) 878-9168

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

LicenseStateTypeSpecialty
45PR00004000NJMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hanger Prosthetics & Orthotics East Inc Prosthetist PastSince Sep 5, 2021 Accepting new patients
Hanger Prosthetics & Orthotics East Inc Prosthetist PastSince Sep 5, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1801564547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PROFESSIONAL PARK DR STE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175516",
            "telephone_number": "704-799-9825",
            "fax_number": "704-799-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PROFESSIONAL PARK DR STE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175516",
            "telephone_number": "704-999-8257",
            "fax_number": "704-799-9826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 Hartness Rd",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286773425",
            "country_code": "US",
            "telephone_number": "704-878-9168",
            "fax_number": "704-871-0655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MATTHEW",
        "credential": "CP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NJ",
            "license": "45PR00004000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.