NPIMap

Organization Active NPI

Mat Prac Group, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Louisville, KY
National Provider Identifier
1083093207
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
MAT PRAC GROUP, LLC
Practice address
204 S Floyd St
Box 8
Louisville, KY 40202-1208
Phone
(502) 681-5752
NPI assigned
May 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Authorized official

Name
Bill Dawson
Title
Coo
Phone
(502) 681-5752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RA0401X Primary

Addresses

Primary practice location

204 S Floyd St
Box 8
Louisville, KY 40202-1208

Mailing address

204 S Floyd St
Box 8
Louisville, KY 40202-1208
Phone (502) 681-5752

National Provider Directory

National Provider Directory

Locations

204 S Floyd St
#8
Louisville, KY 40202
Phone (502) 681-5752

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1083093207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S FLOYD ST",
            "address_2": "BOX 8",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021208",
            "telephone_number": "502-681-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S FLOYD ST",
            "address_2": "BOX 8",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021208",
            "telephone_number": "502-681-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT PRAC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "502-681-5752"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.