Individual provider Active NPI

John Mathis, RN

  • Clinical Informatics (Pathology) Physician
  • Durham, NC
National Provider Identifier
1497523328
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Informatics (Pathology) PhysicianTaxonomy code 207ZC0008X
License
263018 Issued in NC
Practice address
2702 Oberlin Dr
Durham, NC 27705-1631
Phone
(941) 387-5558
NPI assigned
Dec 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 263018 NC
Oncology Registered Nurse 163WX0200X 263018 NC
Clinical Informatics (Pathology) Physician 207ZC0008X 263018 NC Primary

Addresses

Primary practice location

2702 Oberlin Dr
Durham, NC 27705-1631

Mailing address

2702 Oberlin Dr
Durham, NC 27705-1631
Phone (941) 387-5558

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
263018NCMDClinical Informatics (Pathology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1497523328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 OBERLIN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277051631",
            "telephone_number": "941-387-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 OBERLIN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277051631",
            "telephone_number": "941-387-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NC",
            "license": "263018",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "NC",
            "license": "263018",
            "primary": false
        },
        {
            "code": "207ZC0008X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Informatics",
            "state": "NC",
            "license": "263018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.