Active NPI
Holly Marie Mattoes, PHARM.D.
- Pharmacist
- Providence, RI
National Provider Identifier
1174815344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH04101
- Practice address
- 1200 N Main St
Providence, RI 02904-1820 - Phone
- (401) 272-3048
- Fax
- (401) 621-1888
- NPI assigned
- May 6, 2011
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH04101 | RI | Primary |
| Pharmacist | 183500000X | PS45992 | FL | |
| Pharmacist | 183500000X | PH232472 | MA | |
| Pharmacist | 183500000X | PCT0009149 | CT |
Addresses
Primary practice location
1200 N Main St
Providence, RI 02904-1820
Mailing address
1200 N Main St
Providence, RI 02904-1820
Phone (401) 272-3048
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT0009149 | CT | MD | Pharmacist |
| PS45992 | FL | MD | Pharmacist |
| PH232472 | MA | MD | Pharmacist |
| RPH04101 | RI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maxi Drug South LP | Past | Accepting new patients | |
| Maxi Drug South LP | Past | 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.
-
- Community/Retail Pharmacy
- Providence, RI
- NPI 1013017441
-
- Community/Retail Pharmacy
- Providence, RI
- NPI 1982091468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1174815344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029041820",
"telephone_number": "401-272-3048",
"fax_number": "401-621-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029041820",
"telephone_number": "401-272-3048",
"fax_number": "401-621-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOES",
"first_name": "HOLLY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-06",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RPH04101",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS45992",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH232472",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT0009149",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.