Kimberly Dawn Matchett, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1099196 Issued in TX

Practice address

412 Mystic River TRL
Fort Worth, TX 76131-4553

Phone

(208) 640-6183

NPI assigned

Nov 16, 2022

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Joanna Eernisse, PLLC

  dba Just Be You., Psychiatry

  • Psychiatry Physician
  • Lewisville, TX
  • NPI 1396321253
  NPD (past)

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1427767524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 MYSTIC RIVER TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761314553",
            "telephone_number": "208-640-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 MYSTIC RIVER TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761314553",
            "telephone_number": "208-640-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATCHETT",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1099196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Masvida Health Care Solutions LLC (JMeds)
• Jeannie Mata, LPC-A
• Mariel Joselin Mata, OD
• Sara Matani, M.D.
• Sarah J Matches, DO
• Cynthia Mate
• Kara Diane Matej Leon, LCSW
• Maternal Counseling Collaborative PLLC
• Lein Mathbout, MBBS
• Alvin J Mathe, DO

• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.