Individual provider Active NPI

Joanne M O'Malley-Mattio, RN

  • Home Health Registered Nurse
  • Neenah, WI
National Provider Identifier
1225324874
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
165128-30 Issued in WI
Practice address
1497 Whitetail Dr
Neenah, WI 54956-4485
Phone
(920) 720-0922
NPI assigned
Jun 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 165128-30 WI Primary

Addresses

Primary practice location

1497 Whitetail Dr
Neenah, WI 54956-4485

Mailing address

1497 Whitetail Dr
Neenah, WI 54956-4485
Phone (920) 720-0922

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
165128-30WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1225324874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 WHITETAIL DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564485",
            "telephone_number": "920-720-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 WHITETAIL DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564485",
            "telephone_number": "920-720-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY-MATTIO",
        "first_name": "JOANNE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "165128-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.

Verify at the official NPI Registry.