Active NPI
Mia Bettina Feliciano Matias, M.D.
- Pediatrics Physician
- Athens, TN
National Provider Identifier
1093838401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD49483
- Practice address
- 111 Epperson St
Athens, TN 37303-3478 - Phone
- (423) 745-5955
- Fax
- (423) 745-6423
- NPI assigned
- Apr 9, 2007
- Last updated
- Mar 11, 2014
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD49483 | TN | Primary |
Addresses
Primary practice location
111 Epperson St
Athens, TN 37303-3478
Mailing address
111 Epperson St
Athens, TN 37303-3478
Phone (423) 745-5955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1531351 | Medicaid | TN |
Other names 1
- Ms. Mia Bettina Matias
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD49483 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Pediatrics, PLLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- dr_mia_matias@yourcarecommunity.org
- mia.matias@covpeds.directbygreenway.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394496000000",
"number": "1093838401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 EPPERSON ST",
"city": "ATHENS",
"state": "TN",
"postal_code": "373033478",
"telephone_number": "423-745-5955",
"fax_number": "423-745-6423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 EPPERSON ST",
"city": "ATHENS",
"state": "TN",
"postal_code": "373033478",
"telephone_number": "423-745-5955",
"fax_number": "423-745-6423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATIAS",
"first_name": "MIA BETTINA",
"middle_name": "FELICIANO",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2014-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD49483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1531351",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MIA",
"last_name": "MATIAS",
"middle_name": "BETTINA",
"prefix": "MS.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Athens, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.