Individual provider Active NPI

Johnna Matias

  • Licensed Practical Nurse
  • Niagara Falls, NY
National Provider Identifier
1063883189
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
285809 Issued in NY
Practice address
2225 Tuscarora Rd
Niagara Falls, NY 14304-1814
Phone
(716) 343-0796
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 285809 NY Primary

Addresses

Primary practice location

2225 Tuscarora Rd
Niagara Falls, NY 14304-1814

Mailing address

2225 Tuscarora Rd
Niagara Falls, NY 14304-1814

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

LicenseStateTypeSpecialty
285809NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1063883189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 TUSCARORA RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 TUSCARORA RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041814",
            "telephone_number": "716-343-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIAS",
        "first_name": "JOHNNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "285809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.