Kpah Charles Matadi Jr., PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH6594 Issued in ND

Practice address

400 Burdick Expy E Ste 201
Minot, ND 58701-4769

Phone

(701) 857-7900

NPI assigned

Sep 16, 2024

Sex

Male

Sole proprietor

No

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.

• Medical Arts Outpatient Services, Inc.

  • Community/Retail Pharmacy
  • Minot, ND
  • NPI 1093764599
  NPD (past)
• Medical Arts Outpatient Services, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Minot, ND
  • NPI 1104527647
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2024.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1093542995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 31ST AVE SW APT 450",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BURDICK EXPY E STE 201",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014769",
            "telephone_number": "701-857-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATADI",
        "first_name": "KPAH",
        "middle_name": "CHARLES",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary J Solberg
• Lana Mascarena
• Kirk Layne Mason, D.C.
• Kimberly Ann Massine
• Jennifer Masters
• Deja A Mathis
• Anisa Mathson, OTR/L
• Michelle Mathura, RDN, LRD, CDE
• Dawn D Mattern, MD
• Steven R Mattson, MD

• All providers in Minot, ND
• Pharmacist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.