Individual provider Active NPI

Cynthia L Mattoni, NP

  • Family Nurse Practitioner
  • Hudson, OH
National Provider Identifier
1447480207
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA. 10788-NP Issued in OH
Practice address
1320 Corporate Dr
Suite 200
Hudson, OH 44236-4442
Phone
(330) 655-2668
Fax
(330) 342-5608
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA. 10788-NP OH Primary

Addresses

Primary practice location

1320 Corporate Dr
Suite 200
Hudson, OH 44236-4442

Mailing address

1320 Corporate Dr
Suite 200
Hudson, OH 44236-4442
Phone (330) 655-2668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1489AKMDPharmacist
COA. 10788-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium Past Accepting new patients
Ohio Em-I Medical Services, Professional Association Past Accepting new patients
Erie Banks Emergency Physicians LLC Past Accepting new patients
Gustavus Community Clinic Inc Family Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1447480207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 CORPORATE DR",
            "address_2": "SUITE 200",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364442",
            "telephone_number": "330-655-2668",
            "fax_number": "330-342-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 CORPORATE DR",
            "address_2": "SUITE 200",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364442",
            "telephone_number": "330-655-2668",
            "fax_number": "330-342-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTONI",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA. 10788-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.