Alisha Dawn Mattern, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11025669 Issued in FL

Practice address

1120 S 1St St
Immokalee, FL 34142-4303

Phone

(239) 867-3400

NPI assigned

Jan 15, 2022

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seminole Tribe of Florida Health Dept.

  • Primary Care Clinic/Center
  • Hollywood, FL
  • NPI 1144551748

  TX

  Medicare reassignment NPD
• Mercy East Ambulatory Services LLC

  dba Mercy-GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Chesterfield, MO
  • NPI 1134673148
  Medicare reassignment NPD
• Seminole Tribe of Florida

  • Primary Care Clinic/Center
  • Clewiston, FL
  • NPI 1740551530
  NPD

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

{
    "created_epoch": "1642204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1528719085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S 1ST ST",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341424303",
            "telephone_number": "239-867-3400",
            "fax_number": "239-657-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S 1ST ST",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341424303",
            "telephone_number": "239-867-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "ALISHA",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-15",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022001544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Concepcion Lopez-Perez, LCSW
• Emlyn Louis, M.D.
• Michael Luvera, PHARMD, CPH
• Elizabeth Irene Maldonado
• Julie Alexandra Mancera Loftin, D.M.D
• Giuliana Farias McQuirt, PSY.D.
• Angelique Melendez-Blanch, PSYD
• Jean Kesnold Mesidor, PHD
• Sandra Juanita Milan, MD
• Laverne Beal Miller, M.ED

• Family Nurse Practitioner in Immokalee, FL
• Providers in Immokalee, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.