Individual provider Active NPI

Matthew Carson Ponder, MD,DVM

  • Emergency Medicine Physician
  • Washington, DC
National Provider Identifier
1114026234
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
052001 Issued in GA
Practice address
Department of State 2401 E Street NW
Washington, DC 20522-1430
Phone
(844) 355-7673
Fax
(844) 355-7673
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 052001 GA Primary

Addresses

Primary practice location

Department of State 2401 E Street NW
Washington, DC 20522-1430

Mailing address

5010 Warsaw PL Apt 31
Dulles, VA 20189-5010
Phone (844) 355-7673

Other identifiers 1

IdentifierTypeStateIssuer
33439257MedicaidCO

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Emergency Physicians LLC Emergency Medicine Past Accepting new patients
South Fulton Emergency Physicians, LLC Emergency Medicine PastSince Feb 9, 2020 Accepting new patients
North Florida Emergency Physicians Emergency Medicine Past Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: madeleine.ponder@westgahealth.gadirect.net

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1114026234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 WARSAW PL APT 31",
            "city": "DULLES",
            "state": "VA",
            "postal_code": "201895010",
            "telephone_number": "844-355-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF STATE 2401 E STREET NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205221430",
            "telephone_number": "844-355-7673",
            "fax_number": "844-355-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "MATTHEW",
        "middle_name": "CARSON",
        "name_prefix": "Dr.",
        "credential": "MD,DVM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "052001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33439257",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.