Active NPI
Raymond Lewis Mathis, D.O.
- Family Medicine Physician
- Brandenburg, KY
National Provider Identifier
1295066934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01978
- Practice address
- 65 Cedar Vista Dr
Brandenburg, KY 40108 - Phone
- (270) 422-5470
- Fax
- (270) 422-2567
- NPI assigned
- Jan 20, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01978 | KY | Primary |
Addresses
Primary practice location
65 Cedar Vista Dr
Brandenburg, KY 40108
Mailing address
65 Cedar Vista Dr
Brandenburg, KY 40108
Phone (270) 422-5470
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01978 | KY | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263945600000",
"number": "1295066934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 CEDAR VISTA DR",
"city": "BRANDENBURG",
"state": "KY",
"postal_code": "40108",
"telephone_number": "270-422-5470",
"fax_number": "270-422-2567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 CEDAR VISTA DR",
"city": "BRANDENBURG",
"state": "KY",
"postal_code": "40108",
"telephone_number": "270-422-5470",
"fax_number": "270-422-2567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "RAYMOND",
"middle_name": "LEWIS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-20",
"last_updated": "2010-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "01978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandenburg, KY
- Stephen Robert Lee, D.D.S.
- Lincoln Trail District Health Department
- Mallory Wathen Lynch, APRN
- Carolyn Ruth Margle, LPCC
- Jeffrey Allen Marr, IDMT
- Karen Matti, LMT
- Katrina Ray McCoy, APRN
- Meade Association of Remarkable Citizens
- Meade County Board of Education
- Meade County Chiropractic & Sports Rehab PSC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.