Gordon Patrick Mattimoe, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

709909 Issued in TX

Practice address

208 NW 2ND St
Andrews, TX 79714-6308

Phone

(432) 524-1441

Fax

(432) 524-1461

NPI assigned

Oct 4, 2012

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Nurse Practitioner

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.

• Rachel Shireen Golpanian MD P.C.

  • Procedural Dermatology Physician
  • New York, NY
  • NPI 1821927104
  NPD (past)
• Scheiner Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1639692205
  NPD (past)

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1497007116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8228 SAN ANTONIO ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658527",
            "telephone_number": "432-524-1441",
            "fax_number": "432-524-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 NW 2ND ST",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "797146308",
            "telephone_number": "432-524-1441",
            "fax_number": "432-524-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIMOE",
        "first_name": "GORDON",
        "middle_name": "PATRICK",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "709909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logovita, PLLC
• Shanda Kristen Lyle, PTA
• James Dale Martin, RPH
• Raithel Jean Martin, MSE, LAT, ATC
• Kelley Deming Mathis, RN
• Mazzy Medical
• Debra Lynne McCullough, ADVCD PRACTICE NURSE
• Medical Park Pharmacy, Inc
• Mekason Pharmacy Odessa, Inc
• Jordan Mendoza, FNP-C

• Family Nurse Practitioner in Andrews, TX
• Providers in Andrews, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.