Active NPI
Tatiana Matthews
- Nurse's Aide
- Detroit, MI
National Provider Identifier
1073290409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 0317202329043
- Practice address
- 15491 Heyden St
Detroit, MI 48223-1746 - Phone
- (313) 618-3502
- NPI assigned
- Jun 28, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 0317202329043 | MI | Primary |
Addresses
Primary practice location
15491 Heyden St
Detroit, MI 48223-1746
Mailing address
15491 Heyden St
Detroit, MI 48223-1746
Phone (313) 618-3502
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 |
|---|---|---|---|
| 0317202329043 | MI | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1073290409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15491 HEYDEN ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482231746",
"telephone_number": "313-618-3502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15491 HEYDEN ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482231746",
"telephone_number": "313-618-3502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "TATIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MI",
"license": "0317202329043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.