Mary Kathleen Matzko, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

18599 Issued in SC

Practice address

14 Richland Medical Park Dr Ste 410
Columbia, SC 29203-6878

Phone

(803) 434-8740

Fax

(803) 434-8749

NPI assigned

Dec 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• St Francis Physician Services Inc

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295769438
  NPD (past)

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1417388141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-293-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 410",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036878",
            "telephone_number": "803-434-8740",
            "fax_number": "803-434-8749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Saint Francis Dr",
            "address_2": "Suite 340",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296013965",
            "country_code": "US",
            "telephone_number": "864-546-3699",
            "fax_number": "864-546-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATZKO",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "18599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Fisher Mattocks, M.D.
• Myrna L. Mattos, R.N.
• Thomas F Mattox, M.D.
• Mattress Warehouse Inc.
• Megan A Matusiak, DPT
• Matzner Family Chiropractic PC
• Daniel E. Matzner, D.C.
• George Frederic Mau, D.MIN.,M.A.,M.DIV.,L
• Lori P Mauldin, PA-C
• Samantha Maultbay, RBT

• Adult Health Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.