NPIMap

Individual provider Active NPI

Matthew Bryant Mitchell, DPT

  • Physical Therapist
  • Warwick, RI
National Provider Identifier
1831508662
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02703 Issued in RI
Practice address
400 Bald Hill Rd #511
Warwick, RI 02886
Phone
(401) 738-8100
NPI assigned
Aug 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT02703 RI Primary
Physical Therapist 225100000X 21164 MA
Physical Therapist 225100000X 2305208771 VA

Addresses

Primary practice location

400 Bald Hill Rd #511
Warwick, RI 02886

Mailing address

125 Goff Ave
Apartment 1101
Pawtucket, RI 02860
Phone (609) 339-6007

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
21164MAMDPhysical Therapist
PT02703RIMDPhysical Therapist
2305208771VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1831508662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 GOFF AVE",
            "address_2": "APARTMENT 1101",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "609-339-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BALD HILL RD #511",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-738-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MATTHEW",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02703",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21164",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.