Active NPI
Matthew Charles Knapp, PT
- Physical Therapist
- Pontiac, IL
National Provider Identifier
1831446731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070011051
- Practice address
- 2500 W Reynolds St
Pontiac, IL 61764-9774 - Phone
- (815) 842-4580
- Fax
- (815) 842-6893
- NPI assigned
- Aug 9, 2012
- 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 | 070011051 | IL | Primary |
Addresses
Primary practice location
2500 W Reynolds St
Pontiac, IL 61764-9774
Mailing address
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-4580
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 |
|---|---|---|---|
| 070011051 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1831446731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649774",
"telephone_number": "815-842-4580",
"fax_number": "815-842-6893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649774",
"telephone_number": "815-842-4580",
"fax_number": "815-842-6893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNAPP",
"first_name": "MATTHEW",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-09",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070011051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.