Individual provider Active NPI

Matt C Mann

  • Other Technician
  • Dallas, TX
National Provider Identifier
1376025478
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
License
ATP89441 Issued in TX
Practice address
2601 W Mockingbird LN Ste 101
Dallas, TX 75235-5630
Phone
(214) 951-9710
Fax
(214) 951-9720
NPI assigned
Sep 5, 2018
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X ATP89441 TX Primary

Addresses

Primary practice location

2601 W Mockingbird LN Ste 101
Dallas, TX 75235-5630

Mailing address

2601 W Mockingbird LN Ste 101
Dallas, TX 75235-5630
Phone (214) 951-9710

Other identifiers 1

IdentifierTypeStateIssuer
89441OtherTXATP LICESNSE

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

LicenseStateTypeSpecialty
ATP89441TXMDOther Technician

Practice roles

OrganizationSpecialtyStatusNew patients
MMS Equipment of Dallas Central Inc. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1376025478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 W MOCKINGBIRD LN STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355630",
            "telephone_number": "214-951-9710",
            "fax_number": "214-951-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 W MOCKINGBIRD LN STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355630",
            "telephone_number": "214-951-9710",
            "fax_number": "214-951-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "MATT",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "TX",
            "license": "ATP89441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATP LICESNSE",
            "identifier": "89441",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.