Matushka Olga Michael Maternity Associates, Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MATUSHKA OLGA MICHAEL MATERNITY ASSOCIATES, INC

Practice address

116 18TH Ave S
Nampa, ID 83651-4841

Phone

(208) 639-2700

Fax

(208) 639-2736

NPI assigned

Jul 5, 2018

Last updated

Nov 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kellie Northam, CNMNPI 1053650010

Title

Ceo

Phone

(712) 828-0234

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kellie Ann Northam, PMHNP-BC, CNM

  • Psychiatric/Mental Health Nurse Practitioner
  • Nampa, ID
  • NPI 1053650010
  Authorized official Same address or phone
• Christine Marie Radsma, LM, CPM

  • Midwife
  • Eagle, ID
  • NPI 1972273159
  NPD (past)

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1487140265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 13TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514618",
            "telephone_number": "712-828-0234",
            "fax_number": "208-965-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 18TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514841",
            "telephone_number": "208-639-2700",
            "fax_number": "208-639-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATUSHKA OLGA MICHAEL MATERNITY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "NORTHAM",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-828-0234",
        "authorized_official_credential": "CNM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": "ID",
            "license": "CNM81-A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brinley N Matous
• Stuart Matson
• Matthew a. Fowler, D.M.D., P.C.
• Colleen Matthews, MS, CCC-SLP
• Ronda L. Mattley, D.C.
• Rachel Lynn Mauden
• Reiley E Maupin
• Eric R Maus, PAC
• Cynthia Anne Mauzerall, LCPC
• Alicia Elizabeth May, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.