Cody Matson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60967912 Issued in WA

Practice address

2199 W Ironwood Center Dr
Coeur D Alene, ID 83814-2639

Phone

(208) 625-4888

Fax

(208) 625-5734

NPI assigned

Oct 26, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Spokane Behavioral Health LLC

  • Psychiatric Hospital
  • Spokane, WA
  • NPI 1932698107
  Medicare reassignment NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Diagnostic Radiology Physician
  • Covington, WA
  • NPI 1578803839

  Nurse Practitioner

  NPD
• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  NPD (past)

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1568974822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 N MONROE ST STE 271",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012623",
            "telephone_number": "208-718-2528",
            "fax_number": "509-232-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2199 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-625-4888",
            "fax_number": "208-625-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSON",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP67131",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G140540",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "NP67131",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60967912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Joelle Martinez
• Paige Martini
• Mason Park Healthcare, Inc.
• Twyla Jean Masterson, RN, NP
• Elizabeth Mathes
• Matteson Implant and Reconstructive Dentistry PC.
• Jesseca Matthews
• Betty E Maxwell, CBRS
• Diana May, LMSW
• Madeline May

• Psychiatric/Mental Health Nurse Practitioner in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.