Active NPI
Richard Alan Matheny, PH.D.
- Clinical Psychologist
- Muldrow, OK
National Provider Identifier
1073662649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301004006
- Practice address
- 108149 S 4803 Rd
Muldrow, OK 74948-7681 - Phone
- (918) 875-2920
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301004006 | MI | Primary |
Addresses
Primary practice location
108149 S 4803 Rd
Muldrow, OK 74948-7681
Mailing address
108149 S 4803 Rd
Muldrow, OK 74948-7681
Phone (918) 875-2920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68OF34973 | Other | MI | BLUE CROSS AND BLUE SHIELD (TRADITIONAL) |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301004006 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1073662649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108149 S 4803 RD",
"city": "MULDROW",
"state": "OK",
"postal_code": "749487681",
"telephone_number": "918-875-2920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108149 S 4803 RD",
"city": "MULDROW",
"state": "OK",
"postal_code": "749487681",
"telephone_number": "918-875-2920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHENY",
"first_name": "RICHARD",
"middle_name": "ALAN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301004006",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIELD (TRADITIONAL)",
"identifier": "68OF34973",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muldrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.