Individual provider Active NPI

William B Matteson, RT

  • Radiologic Technologist
  • Ridgecrest, CA
National Provider Identifier
1518167774
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
RHF78992 Issued in CA
Practice address
928 S Yorktown St
Ridgecrest, CA 93555-5144
Phone
(408) 370-9080
NPI assigned
Jul 24, 2007
Last updated
Jul 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X RHF78992 CA Primary

Addresses

Primary practice location

928 S Yorktown St
Ridgecrest, CA 93555-5144

Mailing address

928 S Yorktown St
Ridgecrest, CA 93555-5144
Phone (408) 370-9080

Other identifiers 1

IdentifierTypeStateIssuer
340660OtherCATHE AMERICAN REGISTRY OF

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

State licenses

LicenseStateTypeSpecialty
RHF78992CAMDRadiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1518167774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 S YORKTOWN ST",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555144",
            "telephone_number": "408-370-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 S YORKTOWN ST",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555144",
            "telephone_number": "408-370-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "RT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "RHF78992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE AMERICAN REGISTRY OF",
            "identifier": "340660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.