Active NPI
Pamela Michelle Mattox, MS.ED
- Developmental Therapist
- Morehead, KY
National Provider Identifier
1104034677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 375 Hazel Tree LN
Morehead, KY 40351-7737 - Phone
- (606) 780-9213
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
375 Hazel Tree LN
Morehead, KY 40351-7737
Mailing address
375 Hazel Tree LN
Morehead, KY 40351-7737
Phone (606) 678-0921
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396224000000",
"number": "1104034677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 HAZEL TREE LN",
"city": "MOREHEAD",
"state": "KY",
"postal_code": "403517737",
"telephone_number": "606-678-0921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 HAZEL TREE LN",
"city": "MOREHEAD",
"state": "KY",
"postal_code": "403517737",
"telephone_number": "606-780-9213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOX",
"first_name": "PAMELA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "MS.ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2014-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morehead, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.