Individual provider Active NPI

Matthew Edward Lankist, ARNP

  • Nurse Practitioner
  • Marianna, FL
National Provider Identifier
1073536561
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2899592 Issued in FL
Practice address
4970 Highway 90
Marianna, FL 32446-6802
Phone
(850) 718-5620
Fax
(850) 718-5670
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2899592 FL Primary

Addresses

Primary practice location

4970 Highway 90
Marianna, FL 32446-6802

Mailing address

PO Box 6374
Marianna, FL 32447-6374
Phone (850) 326-1918

Other identifiers 2

IdentifierTypeStateIssuer
302183100MedicaidFL
Y6876ZOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170510001954 FL Order and Referring Only - Nurse Practitioner 7911059274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2899592FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1073536561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6374",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324476374",
            "telephone_number": "850-326-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4970 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466802",
            "telephone_number": "850-718-5620",
            "fax_number": "850-718-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANKIST",
        "first_name": "MATTHEW",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2899592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302183100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y6876Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.