Kevin Matteson MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

39709 Issued in CO

Legal business name

KEVIN MATTESON MD PC

Practice address

111 N Park St
Cortez, CO 81321-3340

Phone

(970) 565-6670

Fax

(970) 565-6673

NPI assigned

Aug 25, 2008

Organization subpart

No

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

Authorized official

Name

Kevin M Matteson, MD

Title

President

Phone

(970) 565-6670

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1063669786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N PARK ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213340",
            "telephone_number": "970-565-6670",
            "fax_number": "970-565-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PARK ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213340",
            "telephone_number": "970-565-6670",
            "fax_number": "970-565-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN MATTESON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "MATTESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-565-6670",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "39709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Michelle Jones, M.D.
• Matthew R Kamper, M.D.
• Karen D Libsch MD PC
• Kevin Ray Keith, MS CCC SLP
• Casey Kennedy, NCTMB
• Cara Kropp
• Maeselle Tissnolthtos La Paz
• Amber C Laird, PHARMD
• Casie C Lamunyon, LPC
• Stevi Larue, CPHT

• Specialist in Cortez, CO
• Providers in Cortez, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.