Active NPI
Joyce K Matondane
- Physical Therapist
- Morrisville, NC
National Provider Identifier
1851552475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11210
- Practice address
- 504 Perrault Dr
Morrisville, NC 27560-8633 - Phone
- (269) 753-2194
- Fax
- (919) 467-2148
- NPI assigned
- Jun 17, 2008
- Last updated
- Mar 20, 2009
- Sex
- Female
- 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 | 11210 | NC | Primary |
Addresses
Primary practice location
504 Perrault Dr
Morrisville, NC 27560-8633
Mailing address
504 Perrault Dr
Morrisville, NC 27560-8633
Phone (269) 753-2194
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 069CN | Other | NC | BCBS |
| DO0034 | Other | NC | MEDICARE RAILROAD |
| P00651353 | Other | NC | MEDICARE RAILROAD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11210 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independence Health PA | Past | Accepting new patients | |
| Independence Medical, PA | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Smithfield, NC
- NPI 1184882094
-
- Geriatric Medicine (Family Medicine) Physician
- Smithfield, NC
- NPI 1700845112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237507200000",
"number": "1851552475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 PERRAULT DR",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275608633",
"telephone_number": "269-753-2194",
"fax_number": "919-467-2148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 PERRAULT DR",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275608633",
"telephone_number": "269-753-2194",
"fax_number": "919-467-2148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATONDANE",
"first_name": "JOYCE",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2009-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "11210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "069CN",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "DO0034",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00651353",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morrisville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.