Matthew T Vander Woude, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

S1942 Issued in TX

Practice address

3111 McCann Rd
Longview, TX 75605-7842

Phone

(903) 753-1212

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Moreno Valley, CA
  • NPI 1629018460
  NPD (past)
• Nevada Em-I Silver-Homansky Medical Services Professional Corporation

  • Emergency Medicine Physician
  • Pahrump, NV
  • NPI 1881932721
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1376546424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 MCCANN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057842",
            "telephone_number": "903-753-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 MCCANN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057842",
            "telephone_number": "903-753-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280436",
            "country_code": "US",
            "telephone_number": "702-671-6845",
            "fax_number": "702-671-6883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDER WOUDE",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S1942",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "934",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201875024",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Kristine Van Reenen, FNP
• Donald Joe Van Sandt, O.D.
• Stephanie Vana
• Jamie G. Vanbiber, MAMFT, LPC
• Shonna Vance, LCSW
• Lisa Jill Vandiemen, FNP
• Paige Therese Vanmeter
• Mary Lynn Vassar, RD
• Christin Vaughan, PHARMD
• David M Vaughan, RPH

• Emergency Medicine Physician in Longview, TX
• Providers in Longview, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.