Matthew G Small, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301083155 Issued in MI

Practice address

965 S Bailey Ave
Suite 2-1
South Haven, MI 49090-9701

Phone

(269) 639-2772

Fax

(269) 639-2770

NPI assigned

Jul 18, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1336168871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 S BAILEY AVE",
            "address_2": "SUITE 2-1",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909701",
            "telephone_number": "269-639-2772",
            "fax_number": "269-639-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 S BAILEY AVE",
            "address_2": "SUITE 2-1",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909701",
            "telephone_number": "269-639-2772",
            "fax_number": "269-639-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301083155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4628853 T10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alisa A Somers, DPT
• South Coast Home LLC
• South Haven Area Emergency Services Authority

• Family Medicine Physician in South Haven, MI
• Providers in South Haven, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.