Active NPI
Isabel M Mathieson, D.O.
- Nephrology Physician
- Riverview, FL
National Provider Identifier
1295701365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- OS7215
- Practice address
- 11928 Boyette Rd
Boyette Executive Center
Riverview, FL 33569-5601 - Phone
- (813) 671-5800
- Fax
- (813) 671-9966
- NPI assigned
- Feb 27, 2006
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | OS7215 | FL | Primary |
Addresses
Primary practice location
11928 Boyette Rd
Boyette Executive Center
Riverview, FL 33569-5601
Mailing address
11928 Boyette Road
Boyette Executive Center
Riverview, FL 33556-5601
Phone (813) 671-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 255814900 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS7215 | FL | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236124800000",
"number": "1295701365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11928 BOYETTE ROAD",
"address_2": "BOYETTE EXECUTIVE CENTER",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335565601",
"telephone_number": "813-671-5800",
"fax_number": "813-671-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11928 BOYETTE RD",
"address_2": "BOYETTE EXECUTIVE CENTER",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335695601",
"telephone_number": "813-671-5800",
"fax_number": "813-671-9966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIESON",
"first_name": "ISABEL",
"middle_name": "M",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-27",
"last_updated": "2009-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "OS7215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "255814900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.