Kailey Denajah Mattison

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

43579 Issued in SC

Practice address

975 W Faris Rd
Greenville, SC 29605-4241

Phone

(864) 729-8330

NPI assigned

Sep 23, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1053138891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 FALLS ST UNIT 503",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013555",
            "telephone_number": "864-201-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054241",
            "telephone_number": "864-729-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "KAILEY",
        "middle_name": "DENAJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SC",
            "license": "43579",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "SC",
            "license": "43579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph E Matthews, DMD
• Sarah Simmons Matthews, AF-ACNP
• Shirnett May Matthews, MD
• Chelsea Matthia
• Eldon Lukas Matthia, MD
• Skylar Mattison
• Mattress Outlet of Upstate LLC
• Kiki S Mattress, CRNA
• Joanna Mattson
• John Jay Mauch, DO

• Ambulatory Care Pharmacist in Greenville, SC
• Providers in Greenville, SC by specialty
• Ambulatory Care Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.