Pamela Wagner Vonmatthiessen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.076986 Issued in OH

Practice address

1234 Livermore Street
Yellow Springs, OH 45387

Phone

(937) 767-0147

Fax

(970) 641-9017

NPI assigned

Jul 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jay M. Wolkov DO PC

  • Multi-Specialty Clinic/Center
  • Gunnison, CO
  • NPI 1649368663
  NPD (past)
• Mountian Medicine

  • Family Medicine Physician
  • Crested Butte, CO
  • NPI 1699777912
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1477550762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 LIVERMORE STREET",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "45387",
            "telephone_number": "937-767-0147",
            "fax_number": "970-641-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 LIVERMORE STREET",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "45387",
            "telephone_number": "937-767-0147",
            "fax_number": "970-641-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONMATTHIESSEN",
        "first_name": "PAMELA",
        "middle_name": "WAGNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "38431",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.076986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208659",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70076341",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chanin Tong
• Transitional Life Counseling
• Paul F Vanausdal, MD
• Margaret Veenstra
• Ashley Nicole Marchek Vicen, D.C.
• Heidi M Wade, LPCC
• Keith A Watson, MD
• Margaret Carroll Wehner, MA, CCC-SLP
• Matthew G West, MS
• Christopher Seinjen Wharton, PA-C

• Internal Medicine Physician in Yellow Springs, OH
• Providers in Yellow Springs, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.