Individual provider Active NPI

Courtney Mattia, MD

  • Pediatrics Physician
  • Scottsdale, AZ
National Provider Identifier
1124580345
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
65866 Issued in AZ
Practice address
9827 N 95TH St Ste 105
Scottsdale, AZ 85258-4591
Phone
(480) 860-8488
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 65866 AZ Primary

Addresses

Primary practice location

9827 N 95TH St Ste 105
Scottsdale, AZ 85258-4591

Mailing address

9827 N 95TH St Ste 105
Scottsdale, AZ 85258-4591
Phone (808) 608-4884

Other names 1

  • Courtney Smith Former name

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

LicenseStateTypeSpecialty
65866AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Scottsdale Pediatric Associates Pediatrics PastSince Jul 16, 2023 Accepting new patients
Arbor Medical Partners, LLC Pediatrics PastSince Jul 16, 2023 Accepting new patients

Organizations & group practices 2

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1124580345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9827 N 95TH ST STE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584591",
            "telephone_number": "808-608-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9827 N 95TH ST STE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584591",
            "telephone_number": "480-860-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIA",
        "first_name": "COURTNEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "65866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.