Active NPI
Keegan Mattox, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Richardson, TX
National Provider Identifier
1205445301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 65602
- Practice address
- 160 N Coit Rd
Richardson, TX 75080-5454 - Phone
- (972) 497-9339
- NPI assigned
- Jul 24, 2020
- Last updated
- Jul 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 65602 | TX | Primary |
Addresses
Primary practice location
160 N Coit Rd
Richardson, TX 75080-5454
Mailing address
160 N Coit Rd
Richardson, TX 75080-5454
Phone (972) 497-9339
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 |
|---|---|---|---|
| 65602 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas L P | Past | Accepting new patients | |
| Kroger Texas 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1205445301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 N COIT RD",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750805454",
"telephone_number": "972-497-9339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 N COIT RD",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750805454",
"telephone_number": "972-497-9339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOX",
"first_name": "KEEGAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-24",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "65602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
- Mathis Therapy - a Therapy Connection, LLC (A Therapy Connection)
- Andrea Renee Mathis
- Downie Bushey Mathis, M.S. CCC-SLP, BCBA
- Matrix Rehabilitation- Texas, Inc (MATRIX Orthopedic and Sports Therapy)
- Matrix Rehabilitation-Texas, Inc. (MATRIX Rehabilitation of Garland)
- Amber Maupin, NNP-BC
- Maureen McGeehan, MD, PA
- Maxicare Therapy and Wellness of Dallas
- Michael Maxwell, PHD
- Yolanda Y May, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.