Kirsten Mattson

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

041418450 Issued in IL

Practice address

805 W Fayette Ave
Effingham, IL 62401-2415

Phone

(217) 342-9393

NPI assigned

Mar 30, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• G M Andes LTD

  • Community/Retail Pharmacy
  • Effingham, IL
  • NPI 1740230481
  NPD
• G M Andes LTD

  • Long Term Care Pharmacy
  • Effingham, IL
  • NPI 1932609278
  NPD

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1336727502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W FAYETTE AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W FAYETTE AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012415",
            "telephone_number": "217-342-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "KIRSTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041418450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maranda Lynn Martin, M.A., CCC-SLP
• Mitchell Ryne Martin
• Rafael Martinez
• Abbie Cristine Massengill, M.D.
• Maninder Matharu
• Danielle Mayhaus, APRN
• Jason J McAllaster, D.O.
• Jamie Lee McClain, LCSW
• Joan C. McCord, CRNA
• Nicole McCoy, MA

• General Practice Registered Nurse in Effingham, IL
• Providers in Effingham, IL by specialty
• General Practice Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.