Individual provider Active NPI

Beth Reagan Matherly, ARNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1497045165
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R81261 Issued in OK
Practice address
304 N Meridian Ave Ste D
Oklahoma City, OK 73107-6535
Phone
(405) 943-6465
NPI assigned
Apr 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R81261 OK Primary

Addresses

Primary practice location

304 N Meridian Ave Ste D
Oklahoma City, OK 73107-6535

Mailing address

5300 S Triple X Rd
Choctaw, OK 73020-5419
Phone (405) 391-6951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R81261OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fastcare Medical Clinic of del City Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1497045165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 S TRIPLE X RD",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730205419",
            "telephone_number": "405-391-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MERIDIAN AVE STE D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076535",
            "telephone_number": "405-943-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN MATHERLY",
        "first_name": "BETH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R81261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.