NPIMap

Organization Active NPI

Barry R. Matheson, DDS, MSD PC

  • Periodontics
  • Bristol, VA
National Provider Identifier
1346467511
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401006603 Issued in VA
Legal business name
BARRY R. MATHESON, DDS, MSD PC
Practice address
817 Gate City Highway
Bristol, VA 24201
Phone
(276) 669-1231
Fax
(276) 466-6872
NPI assigned
Apr 19, 2007
Last updated
Aug 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Authorized official

Name
Dr. Barry Robert Matheson, D.D.S., M.S.D.NPI 1639396989
Title
President
Phone
(276) 669-1231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DS0000005057 TN
Periodontics 1223P0300X 14875 TX
Periodontics 1223P0300X 0401006603 VA Primary

Addresses

Primary practice location

817 Gate City Highway
Bristol, VA 24201

Mailing address

817 Gate City Highway
Bristol, VA 24201
Phone (276) 669-1231

National Provider Directory

National Provider Directory

Locations

1055 Skyline Rdg
Bristol, VA 24201
Phone (276) 669-1231

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1346467511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 GATE CITY HIGHWAY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "24201",
            "telephone_number": "276-669-1231",
            "fax_number": "276-466-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 GATE CITY HIGHWAY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "24201",
            "telephone_number": "276-669-1231",
            "fax_number": "276-466-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY R. MATHESON, DDS, MSD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "MATHESON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "276-669-1231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS0000005057",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "14875",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401006603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; 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.