Individual provider Active NPI

Matthew Feldhammer, PHD

  • Clinical Laboratory Director (Non-physician)
  • Jacksonville, FL
National Provider Identifier
1477143733
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
DL49402 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-5076
NPI assigned
Jan 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chemistry Pathology Specialist/Technologist 246QC1000X 1225 DE
Immunology Pathology Specialist/Technologist 246QI0000X
Diplomate Laboratory Management Specialist/Technologist 246QL0901X
Biochemist 246ZB0500X
Clinical Laboratory Director (Non-physician) 247ZC0005X DL49402 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

655 W 8TH St # C504
Jacksonville, FL 32209-6511
Phone (904) 244-5076

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1225DEMDChemistry Pathology Specialist/Technologist
DL49402FLMDClinical Laboratory Director (Non-physician)

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1477143733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST # C504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDHAMMER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QC1000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Chemistry",
            "state": "DE",
            "license": "1225",
            "primary": false
        },
        {
            "code": "246QI0000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246QL0901X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management, Diplomate",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZB0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Biochemist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "FL",
            "license": "DL49402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.