Individual provider Active NPI

Kiera Mattern

  • Athletic Trainer
  • Beaumont, TX
National Provider Identifier
1104380559
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
211 Redbird LN
Beaumont, TX 77705-9801
Phone
(303) 323-5221
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

211 Redbird LN
Beaumont, TX 77705-9801

Mailing address

PO Box 10066
Beaumont, TX 77710-0066
Phone (303) 323-5221

Other practice location 1

1100 North Ave
Grand Junction, CO 81501-3122
Phone (303) 323-5221

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1104380559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10066",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777100066",
            "telephone_number": "303-323-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 REDBIRD LN",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777059801",
            "telephone_number": "303-323-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 North Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815013122",
            "country_code": "US",
            "telephone_number": "303-323-5221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "KIERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.