Individual provider Active NPI

Olivia Demunbrun, PT, DPT

  • Physical Therapist
  • Somerset, KY
National Provider Identifier
1972226348
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008694 Issued in KY
Practice address
100 Hardin LN Ste D
Somerset, KY 42503-3812
Phone
(606) 677-6886
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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 008694 KY Primary

Addresses

Primary practice location

100 Hardin LN Ste D
Somerset, KY 42503-3812

Mailing address

100 Hardin LN Ste D
Somerset, KY 42503-3812
Phone (606) 677-6886

Other identifiers 1

IdentifierTypeStateIssuer
7101031160MedicaidKY

Other names 1

  • Olivia Matlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230124003362 KY Practitioner - Physical Therapist in Private Practice 6709257090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008694KYMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: olivia.matlin@eandbortho.directbygreenway.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1972226348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARDIN LN STE D",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "606-677-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HARDIN LN STE D",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "606-677-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMUNBRUN",
        "first_name": "OLIVIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101031160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MATLIN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.