Robert James Mattox, ED.D

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1489 Issued in GA

Practice address

82 William Way
Ellijay, GA 30540-7231

Phone

(770) 990-9197

NPI assigned

Sep 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bob Mattox Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1487324877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 WILLIAM WAY",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305407231",
            "telephone_number": "770-990-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 WILLIAM WAY",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305407231",
            "telephone_number": "770-990-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "1489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR GA",
            "identifier": "1489",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bobmattox@bellsouth.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "82 William Way",
            "city": "Ellijay",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305407231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BOB",
            "last_name": "MATTOX",
            "credential": "ED.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.