Matrix Medical Network

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

410426 Issued in NY

Legal business name

MATRIX MEDICAL NETWORK

Practice address

21811 120TH Ave
Cambria Heights, NY 11411-2030

Phone

(917) 749-7946

NPI assigned

Jan 9, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Kim Demetrius Cummings-Williams, REGISTERED NURSENPI 1831071216

Title

Clinical Nurse Specialist

Phone

(917) 749-7946

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim Demetrius Cummings-Williams, MSN, RN HEALTH COACH

  • Health Educator
  • Cambria Heights, NY
  • NPI 1831071216
  NPD (past) Authorized official

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1427328392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585199",
            "telephone_number": "917-749-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21811 120TH AVE",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114112030",
            "telephone_number": "917-749-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MEDICAL NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS-WILLIAMS",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "DEMETRIUS",
        "authorized_official_title_or_position": "CLINICAL NURSE SPECIALIST",
        "authorized_official_telephone_number": "917-749-7946",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": "410426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makki Pharmacy & Surgical Inc
• Sytieya Elizabeth Mann-Mills, M.S., COMS
• Krystle Marcoviche, RN
• Krystal Martinez
• Tatiana Massa, RN
• Kimberly Matthews, M.D
• Dominque Mayers
• Cheryl Ann McKay- Mitchell, FNP
• Phelicia McKenzie, RN
• Shirley Ava McLamore

• Health Maintenance Organization in Cambria Heights, NY
• Providers in Cambria Heights, NY by specialty
• Health Maintenance Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.