Gregory A Matlock, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02860 Issued in IA

Practice address

3600 30TH St
Des Moines, IA 50310-5753

Phone

(515) 699-5999

NPI assigned

Jan 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1396723623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "02860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3121640",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080178754",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2121640",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4121640",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jagtaj Matharoo, MD
• Tiffany Nichole Matheny, A.R.N.P.
• Ashley Lynne Mathes, D.O.
• Ellen L Mathes, MSW
• Jessica A Mathisen, PA-C
• Christopher R Matson, DO
• Matta Dental Care PLC
• Mark Richard Matthes, M.D.
• Lawrence W Matthews, DO
• Serena Matuk, LMHC

• Family Medicine Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.