Gossie Colette Heath Mathis, M.D

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

13454 Issued in SC

Practice address

130 Plaza Cir
Santee, SC 29142-9630

Phone

(803) 854-3940

Fax

(803) 854-3945

NPI assigned

Apr 3, 2007

Last updated

Feb 18, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gossie Mathis Other name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Santee Family Medical Center

  • Primary Care Clinic/Center
  • Santee, SC
  • NPI 1326217654
  NPD (past) Authorized official
• Santee Family Medical Center, Inc

  • Clinic/Center
  • Santee, SC
  • NPI 1932427168
  Authorized official Same address or phone
• Santee Family Medical Ctr

  • Primary Care Clinic/Center
  • Santee, SC
  • NPI 1285890186
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1295856557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "SANTEE",
            "state": "SC",
            "postal_code": "291420277",
            "telephone_number": "803-854-3940",
            "fax_number": "803-854-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PLAZA CIR",
            "city": "SANTEE",
            "state": "SC",
            "postal_code": "291429630",
            "telephone_number": "803-854-3940",
            "fax_number": "803-854-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH MATHIS",
        "first_name": "GOSSIE",
        "middle_name": "COLETTE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "13454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPO261",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GOSSIE",
            "last_name": "MATHIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dva Healthcare Renal Care Inc (Santee Dialysis)
• Edisto Regional Health Services Inc (RMC Santee Express Care)
• Latron Elmore
• Lavonya Renee Gilmore, CNA
• Rachel Ramsey Grooms, OTR/L
• Charles Edward Hill
• Delores Gregory Hollen, MA, LPC
• Patrick William Leonard, D.C.
• Deana Lewis, PHARMD
• Living Life Easy Home Care, LLC

• Adolescent Medicine (Internal Medicine) Physician in Santee, SC
• Providers in Santee, SC by specialty
• Adolescent Medicine (Internal Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.