Kim Matthews, FNP

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

110176 Issued in NE

Practice address

21 Rachel Lane
Brevig Mission, AK 99785

Phone

(907) 642-2307

NPI assigned

Jan 16, 2007

Last updated

May 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1265583207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 RACHEL LANE",
            "address_2": "POB 107",
            "city": "BREVIG MISSION",
            "state": "AK",
            "postal_code": "99785",
            "telephone_number": "907-642-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 RACHEL LANE",
            "city": "BREVIG MISSION",
            "state": "AK",
            "postal_code": "99785",
            "telephone_number": "907-642-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NE",
            "license": "110176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Registered Nurse in Brevig Mission, AK
• Providers in Brevig Mission, AK by specialty
• General Practice Registered Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.