Active NPI
Ina J Matthews, PA-C
- Physician Assistant
- Sevierville, TN
National Provider Identifier
1083782833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0430
- Practice address
- 641 Middle Creek Rd
Sevierville, TN 37862-5014 - Phone
- (865) 428-0583
- NPI assigned
- Dec 1, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0430 | TN | Primary |
Addresses
Primary practice location
641 Middle Creek Rd
Sevierville, TN 37862-5014
Mailing address
1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909-2604
Phone (865) 584-4747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3706637 | Other | TN | MEDICARE LEGACY GROUP |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0430 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1083782833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 E WEISGARBER RD",
"address_2": "STE 200",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379092604",
"telephone_number": "865-584-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "641 MIDDLE CREEK RD",
"city": "SEVIERVILLE",
"state": "TN",
"postal_code": "378625014",
"telephone_number": "865-428-0583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "INA",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "0430",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LEGACY GROUP",
"identifier": "3706637",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sevierville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.