Individual provider Active NPI

Reid Alan Matteson, C. PED.

  • Customized Equipment (DME)
  • Sioux Falls, SD
National Provider Identifier
1548336662
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Practice address
112 S Van Eps Ave
Sioux Falls, SD 57103-1734
Phone
(605) 331-3067
Fax
(605) 331-3083
NPI assigned
Nov 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

112 S Van Eps Ave
Sioux Falls, SD 57103-1734

Mailing address

112 S Van Eps Ave
Sioux Falls, SD 57103-1734
Phone (605) 331-3067

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548336662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S VAN EPS AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031734",
            "telephone_number": "605-331-3067",
            "fax_number": "605-331-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S VAN EPS AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031734",
            "telephone_number": "605-331-3067",
            "fax_number": "605-331-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "REID",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "C. PED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.