Individual provider Active NPI

Bryan P Mathieson, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1205022555
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002603A Issued in IN
Practice address
11141 Parkview Plaza Dr Ste 305
Fort Wayne, IN 46845-1715
Phone
(260) 266-8900
Fax
(260) 266-8935
NPI assigned
Sep 20, 2007
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 78183 ID
Nurse Practitioner 363L00000X 71002603A IN Primary
Nurse Practitioner 363L00000X 8890 WI
Family Nurse Practitioner 363LF0000X 0024192011 VA
Family Nurse Practitioner 363LF0000X 26537 TN
Family Nurse Practitioner 363LF0000X 4704427019 MI
Family Nurse Practitioner 363LF0000X 2015002005 MO

Addresses

Primary practice location

11141 Parkview Plaza Dr Ste 305
Fort Wayne, IN 46845-1715

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

601 John St Ste M-325
Kalamazoo, MI 49007-5358
Phone (269) 341-7140

Other practice location 2

410 N State Of Franklin Rd Ste 130
Johnson City, TN 37604-6972
Phone (423) 431-2477

Other practice location 3

999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone (208) 302-2600

Other practice location 4

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 729-3100

Other practice location 5

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-0582

Other identifiers 3

IdentifierTypeStateIssuer
3124112MedicaidOH
200889510MedicaidIN
000000584893OtherINANTHEM

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address bmathieson12165@Direct.Parkviewexchange.com
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
Direct Messaging Address bmathieson@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MO, FL, WI, ID, TN, VA, SC, DC, MI10 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
I20080919000142 IN Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20150330000979 MO Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20160308002190 FL Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20190220001116 WI Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 5 organizations
I20240412000731 ID Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20250321000185 TN Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20250409000469 VA Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20250513002264 SC Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20250710002611 DC Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization
I20251222003438 MI Practitioner - Nurse Practitioner 3476620238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians
Beaufort County Memorial HospitalGroup PAC ID 7810809365, 197 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

2825 Airview Blvd
Portage, MI 49002-1802

3250 Gordonville Rd
Suite 384
Cape Girardeau, MO 63703-5095
Phone (573) 331-5522

601 John St
Kalamazoo, MI 49007-5377

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
78183IDMDNurse Practitioner
71002603AINMDNurse Practitioner
4704427019MIMDFamily Nurse Practitioner
2015002005MOMDFamily Nurse Practitioner
26537TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Midwest Critical Care SC CurrentSince May 1, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Argomed Group LLC CurrentSince Dec 1, 2025 Accepting new patients
University Surgeons, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Mar 6, 2025 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Dec 30, 2018 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Thedacare, Incorporated CurrentSince Apr 26, 2019 Accepting new patients
Bronson Methodist Hospital CurrentSince Dec 1, 2025 Accepting new patients
Urgent Specialty Associates PLLC CurrentSince Mar 1, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 30, 2018 Accepting new patients
Saint Francis Medical Center Nurse Practitioner CurrentSince Feb 6, 2025 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Nurse Practitioner CurrentSince Feb 1, 2023 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Nurse Practitioner Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 27, 2024 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Mar 6, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 30, 2018 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Mar 1, 2025 Accepting new patients
Saint Francis Medical Center CurrentSince Feb 6, 2025 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 27, 2024 Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients
Saint Alphonsus Specialty Services Inc Family Past Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Past Accepting new patients
Parkview Hospital, Inc. Past Accepting new patients

Locations (25 of 35)

1307 S Tamiami Trl
Osprey, FL 34229
Phone (941) 300-9111

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

999 N Curtis Rd
Ste 415
Boise, ID 83706
Phone (208) 302-2600

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

7630 Solutions Ctr
Chicago, IL 60677

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M-325
Kalamazoo, MI 49007
Phone (269) 341-4890

3250 Gordonville Rd
Ste 384
Cape Girardeau, MO 63703
Phone (573) 331-5522

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

955 Ribaut Rd
#C
Beaufort, SC 29902

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

410 N State of Franklin Rd
Ste 130
Johnson City, TN 37604
Phone (423) 431-2460

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

7101 Jahnke Rd
Ste 260
Richmond, VA 23225
Phone (804) 432-2705

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

Interoperability endpoints

  • Direct secure messaging: bmathieson@direct.iuhealth.org
  • Direct secure messaging: bmathieson12165@direct.parkviewexchange.com
  • Direct secure messaging: bmathieson3085058@direct.trinity-health.org
  • Direct secure messaging: bryan.mathieson.1@16436.direct.athenahealth.com
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 27

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 27

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1205022555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR STE 305",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451715",
            "telephone_number": "260-266-8900",
            "fax_number": "260-266-8935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St Ste M-325",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075358",
            "country_code": "US",
            "telephone_number": "269-341-7140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N State Of Franklin Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N Curtis Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061334",
            "country_code": "US",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-729-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-0582",
            "fax_number": "317-962-2082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIESON",
        "first_name": "BRYAN",
        "middle_name": "P",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "78183",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002603A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8890",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024192011",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26537",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704427019",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015002005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3124112",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200889510",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000584893",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmathieson12165@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 305",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 305",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 305",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmathieson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.