Active NPI
Jaimie Leigh Mathews
- Marriage & Family Therapist
- Tyler, TX
National Provider Identifier
1245854496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 203642
- Practice address
- 3334 SSW Loop 323 Ste 114
Tyler, TX 75701-9237 - Phone
- (903) 343-6215
- NPI assigned
- Jun 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 203642 | TX | Primary |
Addresses
Primary practice location
3334 SSW Loop 323 Ste 114
Tyler, TX 75701-9237
Mailing address
3334 SSW Loop 323 Ste 114
Tyler, TX 75701-9237
Phone (903) 343-6215
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 203642 | TX | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| F1Rst - First Responder Stress & Trauma LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
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- NPI 1023627635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591142400000",
"number": "1245854496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3334 SSW LOOP 323 STE 114",
"city": "TYLER",
"state": "TX",
"postal_code": "757019237",
"telephone_number": "903-343-6215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3334 SSW LOOP 323 STE 114",
"city": "TYLER",
"state": "TX",
"postal_code": "757019237",
"telephone_number": "903-343-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "JAIMIE",
"middle_name": "LEIGH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-03",
"last_updated": "2020-06-03",
"certification_date": "2020-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "203642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.