Matthew Daigle, PT – Physical Therapist in Marion, AR

Key facts

NPI: 1962708867
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: PT3330 (AR)
Practice address: 2860 I 55 Service Rd
Ste C
Marion, AR 72364
Phone: (870) 739-8686
Fax: (870) 739-8656
NPI assigned: Feb 10, 2011
Sex: Male
Sole proprietor: Yes

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 and National Provider Directory roles.

Fenter Physical Therapy LLC Physical Therapist · Marion, AR · NPI 1992907067

Medicare reassignment Care Compare group NPD AR · PHYSICAL THERAPIST
Fenter Physical Therapy Durable Medical Equipment & Medical Supplies · West Memphis, AR · NPI 1518384536

NPD (past)

Medicare Care Compare profile

Specialty: Physical Therapist in Private Practice
Education: Other, 2010
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Fenter Physical Therapy LLC (9 clinicians)

Practice addresses (Care Compare)

200 W Broadway
West Memphis, AR 72301-3904
Phone (870) 394-7000

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AR

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20110811000494	AR	Practitioner - Physical Therapist in Private Practice	5799954541	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
PT3330	AR	MD	Physical Therapist

Practice roles

Organization	Specialty	Status	New patients
Fenter Physical Therapy LLC	Physical Therapist	Current since Feb 7, 2011	Accepting new patients
Fenter Physical Therapy		Past	Accepting new patients

Locations

1100 N Main St
Brinkley, AR 72021
Phone (870) 394-7000

300 Eldridge Rd
Ste 1
Forrest City, AR 72335
Phone (870) 394-7000

2860 Interstate 55
Ste C
Marion, AR 72364
Phone (870) 629-9413

2981 W Keiser Ave
Osceola, AR 72370
Phone (870) 738-8532

705 N Sebastian
West Helena, AR 72390
Phone (870) 572-9399

200 W Broadway St
West Memphis, AR 72301
Phone (870) 394-7000

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	PT3330	AR	Yes

Addresses

Primary practice location

2860 I 55 Service Rd
Ste C
Marion, AR 72364

Mailing address

2860 I 55 Service Rd
Ste C
Marion, AR 72364
Phone (870) 739-8686

Other identifiers

Identifier	Type	State	Issuer
187353721	Medicaid	AR

Other providers in Marion, AR

All providers in Marion, AR · Physical Therapist in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.