Active NPI
Matthew Walden, RN
- Registered Nurse
- Vero Beach, FL
National Provider Identifier
1003170515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 626077
- Practice address
- 650 Reef Rd
Vero Beach, FL 32963-2803 - Phone
- (415) 760-0995
- NPI assigned
- Jun 28, 2012
- Last updated
- Jun 28, 2012
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 626077 | CA | Primary |
Addresses
Primary practice location
650 Reef Rd
Vero Beach, FL 32963-2803
Mailing address
650 Reef Rd
Vero Beach, FL 32963-2803
Phone (415) 760-0995
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 626077 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1003170515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 REEF RD",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329632803",
"telephone_number": "415-760-0995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 REEF RD",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329632803",
"telephone_number": "415-760-0995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDEN",
"first_name": "MATTHEW",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-28",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "626077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0931)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-4546)
- Wal-Mart Stores East. LP (Vision Center 30-0931)
- Wal-Mart Stores Inc. (Vision center 30-6520)
- Elizabeth Lauren Walden, APRN, FNP-C
- Walgreen Co (Walgreens #03608)
- Walgreen Co (Walgreens #11737)
- Walgreen Co (Walgreens #04642)
- Walgreen Co (Walgreens #03607)
- Walgreen Co (Walgreens #01127)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.