Individual provider Active NPI

Elizabeth L Mathis, CNP

  • Nurse Practitioner
  • Portsmouth, OH
National Provider Identifier
1003206046
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0034195 Issued in OH
Practice address
1611 27TH St Ste F301
Portsmouth, OH 45662-6931
Phone
(740) 356-7546
Fax
(740) 356-8077
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0034195 OH Primary

Addresses

Primary practice location

1611 27TH St Ste F301
Portsmouth, OH 45662-6931

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-8681

Other identifiers 2

IdentifierTypeStateIssuer
15070756OtherCAQH
7100719560MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabeth.mathis@somc.medicity.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711001883 OH Practitioner - Nurse Practitioner 5395062251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians

Practice addresses (Care Compare)

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

Hospital & facility affiliations

  • Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0034195OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. CurrentSince Sep 12, 2023 Accepting new patients
Somc Medical Care Foundation, Inc. Nurse Practitioner CurrentSince Sep 12, 2023 Accepting new patients

Locations

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1611 27th St
Ste 301
Portsmouth, OH 45662
Phone (740) 354-4491

1611 27th St
Ste F301
Portsmouth, OH 45662
Phone (740) 356-7546

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1003206046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-356-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 27TH ST STE F301",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626931",
            "telephone_number": "740-356-7546",
            "fax_number": "740-356-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0034195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15070756",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100719560",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.mathis@somc.medicity.net",
            "affiliation": "N",
            "endpointDescription": "SOMC Dermatology",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1611 27th St Ste F301",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456626931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.