Kendia Mathieu

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN242351 Issued in GA

Practice address

1495 Duluth Hwy
Ste F PMB 134
Lawrenceville, GA 30043

Phone

(678) 242-9560

NPI assigned

May 21, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Promed Preferred Ga 2 Professional Corporation

  • Internal Medicine Physician
  • Monroe, NY
  • NPI 1033934542

  GA, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1487493334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 DULUTH HWY",
            "address_2": "STE F PMB 134",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "678-242-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 DULUTH HWY",
            "address_2": "STE F PMB 134",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "678-242-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIEU",
        "first_name": "KENDIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN242351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheba Ann Mathew
• Susamma Mathew, MD
• Taniya Mathew, MD
• Bridget Kathleen Mathews, PT, DPT
• Mia M Mathewson, M.D.
• Heather Mathis, LPC
• Jamesia Mathis, LPC
• Matrix Rehabilitation-Georgia, Inc.
• Dashawn Matta
• Tonya Mattei, PAC

• Family Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.