Kristine C Matthias, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5349 Issued in TN

Practice address

156 S Dossett Drive
Johnson City, TN 37614-1702

Phone

(423) 439-4355

Fax

(423) 439-4607

NPI assigned

Oct 24, 2014

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1306241005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70643",
            "address_2": "156 S DOSSETT DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141702",
            "telephone_number": "423-439-4584",
            "fax_number": "423-439-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S DOSSETT DRIVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141702",
            "telephone_number": "423-439-4355",
            "fax_number": "423-439-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHIAS",
        "first_name": "KRISTINE",
        "middle_name": "C",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "5349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009051",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LICENSE",
            "identifier": "5349",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel O Massey III, M.D.
• Erika Masters, NP-C
• Craig Matherne, MD
• Amanda Matney, PHARMD
• Kathleen Rachelle Matteson
• Emilyn Wilson Mattice
• Carol M Maupin-Wheelock, PT,MBA,CERT. MDT
• Ernest David Maupin, DNP, APRN, PMHNP-BC
• Richard Christopher Maupin, PA-C
• Lurelle Louise Maxey, LPC

• Speech-Language Pathologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.