Individual provider Active NPI

Matthew Thomas Gjovig, RN, SRNA

  • Student in an Organized Health Care Education/Training Program
  • Saint Paul, MN
National Provider Identifier
1336964931
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
700 East 7TH Street
Saint Paul, MN 55106-5003
Phone
(715) 553-1502
NPI assigned
Nov 19, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

700 East 7TH Street
Saint Paul, MN 55106-5003

Mailing address

443 Bruce Larson Way
Somerset, WI 54025-9101

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
Credentials
Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1336964931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 BRUCE LARSON WAY",
            "city": "SOMERSET",
            "state": "WI",
            "postal_code": "540259101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 EAST 7TH STREET",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551065003",
            "telephone_number": "715-553-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJOVIG",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "RN, SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.