Abimbola Adenike Matti, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

A1209274 Issued in MN

Practice address

732 E Lake St
Pain Relief Center of Minnesota
Minneapolis, MN 55407-1547

Phone

(612) 516-3737

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, MI, WI, VA, ME5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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.

• Kingsford Physician Services, LLC

  • Hospitalist Physician
  • Pulaski, VA
  • NPI 1871088526
  Medicare reassignment NPD
• Lakeland Medical Practices

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Mainehealth

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MN, WI

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  ME

  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Lakeland Medical Practices

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD
• Mainehealth

  • Skilled Nursing Facility
  • Sanford, ME
  • NPI 1447342209
  NPD
• Spectrum Health Primary Care Partners

  • Nurse Practitioner
  • Grand Rapids, MI
  • NPI 1346480258
  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1386931178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5376 SUNWOOD DRIVE",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553034216",
            "telephone_number": "612-515-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 E LAKE ST",
            "address_2": "PAIN RELIEF CENTER OF MINNESOTA",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071547",
            "telephone_number": "612-516-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTI",
        "first_name": "ABIMBOLA",
        "middle_name": "ADENIKE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "A1209274",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "G0210002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolores Jane Matthews, MA
• Jamie Matthews, DNP, RN-PHN
• Jeanette Nicole Matthews, LMFT
• Justin Matthews, MA
• Sarah Matthiesen
• Margaret Marie Mattingly, LICSW, LP
• Michael Mattingly, DDS
• Shelby Mattison, DPT
• Adam Reed Mattox, D.O.
• Amanda Mattson, PA-C

• Adult Health Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.