Active NPI
Daniel Joseph Matta, DPT, PT, OCS, CSCS
- Physical Therapist
- Decatur, GA
National Provider Identifier
1881902450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011194
- Practice address
- 533 W Howard Ave Ste C1
Decatur, GA 30030 - Phone
- (470) 355-2106
- NPI assigned
- Sep 16, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | PT011194 | GA | Primary |
Addresses
Primary practice location
533 W Howard Ave Ste C1
Decatur, GA 30030
Mailing address
722 Mercer St SE
Atlanta, GA 30312
Phone (470) 355-2106
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 |
|---|---|---|---|
| PT011194 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536278400000",
"number": "1881902450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 MERCER ST SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30312",
"telephone_number": "470-355-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "533 W HOWARD AVE STE C1",
"city": "DECATUR",
"state": "GA",
"postal_code": "30030",
"telephone_number": "470-355-2106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTA",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"credential": "DPT, PT, OCS, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-16",
"last_updated": "2018-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.