Kristi Lynn Mattes, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

201130241LPN Issued in OR

Practice address

506 35TH St
Springfield, OR 97478-5865

Phone

(541) 221-8615

NPI assigned

May 1, 2012

Last updated

May 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristi Lynn Yeack Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1073871711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 35TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785865",
            "telephone_number": "541-221-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 35TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785865",
            "telephone_number": "541-221-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTES",
        "first_name": "KRISTI",
        "middle_name": "LYNN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201130241LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "YEACK",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Zoe Yggdrasil Maver

• Licensed Practical Nurse in Springfield, OR
• Providers in Springfield, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.