Individual provider Active NPI

Matthew Rupiper, PT

  • Physical Therapist
  • Morton, IL
National Provider Identifier
1922312545
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11500 Issued in WI
Practice address
1909 N Morton Ave
Morton, IL 61550-1426
Phone
(309) 266-5488
Fax
(309) 266-9144
NPI assigned
Aug 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11500 WI Primary

Addresses

Primary practice location

1909 N Morton Ave
Morton, IL 61550-1426

Mailing address

1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 266-5488

Other identifiers 1

IdentifierTypeStateIssuer
P00943853OtherILRR MEDICARE

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

LicenseStateTypeSpecialty
11500WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1922312545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 N MORTON AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501426",
            "telephone_number": "309-266-5488",
            "fax_number": "309-266-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 N MORTON AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501426",
            "telephone_number": "309-266-5488",
            "fax_number": "309-266-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPIPER",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00943853",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.