Active NPI
Matt Donald Paulson, R.T.(R)
- Radiologic Technologist
- Mobile, AL
National Provider Identifier
1013531367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 588323
- Practice address
- 3719 Dauphin St
Mobile, AL 36608-1753 - Phone
- (251) 344-9630
- NPI assigned
- Jun 2, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 588323 | AL | Primary |
Addresses
Primary practice location
3719 Dauphin St
Mobile, AL 36608-1753
Mailing address
5909 Cansler Dr
Mobile, AL 36609-7023
Phone (256) 604-3773
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 588323 | AL | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591056000000",
"number": "1013531367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5909 CANSLER DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366097023",
"telephone_number": "256-604-3773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3719 DAUPHIN ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366081753",
"telephone_number": "251-344-9630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "MATT",
"middle_name": "DONALD",
"credential": "R.T.(R)",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-02",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "AL",
"license": "588323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.