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1063892743 NPI number — BRIDGITTE MATTHEWS PT, DPT

NPI Number: 1063892743
Health Care Provider/Practitioner: BRIDGITTE MATTHEWS PT, DPT

Information about “1063892743” NPI (BRIDGITTE MATTHEWS PT, DPT) exists in 1063892743 in HTML format HTML  |  1063892743 in plain Text format TXT  |  1063892743 in PDF (Portable Document Format) PDF  |  1063892743 in an XML format XML  formats.

NPI Number : 1063892743 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063892743",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MATTHEWS",
    "FirstName": "BRIDGITTE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HOOKER",
    "OtherFirstName": "BRIDGITTE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PT, DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "350 NEW FIDELITY CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GARNER",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27529-2665",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "919-258-2714",
    "MailingAddressFaxNumber": "410-648-4878",
    "FirstLinePracticeLocationAddress": "6856 RICHMOND HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALEXANDRIA",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22306",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "571-348-1201",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/08/2015",
    "LastUpdateDate": "07/15/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "042291",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "42613",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "2305213344",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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