Active NPI
Reyna Marlene Mateo, AGPCNP-BC
- Primary Care Nurse Practitioner
- Iron City, TN
National Provider Identifier
1316739758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 29507
- Practice address
- 1270 Cook Rd
Iron City, TN 38463-4625 - Phone
- (931) 724-4590
- NPI assigned
- May 21, 2025
- Last updated
- May 21, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 29507 | TN | Primary |
Addresses
Primary practice location
1270 Cook Rd
Iron City, TN 38463-4625
Mailing address
1270 Cook Rd
Iron City, TN 38463-4625
Phone (931) 724-4590
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29507 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1316739758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 COOK RD",
"city": "IRON CITY",
"state": "TN",
"postal_code": "384634625",
"telephone_number": "931-724-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 COOK RD",
"city": "IRON CITY",
"state": "TN",
"postal_code": "384634625",
"telephone_number": "931-724-4590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEO",
"first_name": "REYNA",
"middle_name": "MARLENE",
"credential": "AGPCNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-21",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TN",
"license": "29507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iron City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.