Individual provider Active NPI

Carolyn Mattson, ARNP

  • Family Nurse Practitioner
  • Bellingham, WA
National Provider Identifier
1598349235
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61166688 Issued in WA
Practice address
2592 Kwina Rd
Bellingham, WA 98226-9278
Phone
(360) 384-0464
NPI assigned
May 10, 2021
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61166688 WA Primary

Addresses

Primary practice location

2592 Kwina Rd
Bellingham, WA 98226-9278

Mailing address

2592 Kwina Rd
Bellingham, WA 98226-9278

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210608002024 WA Practitioner - Nurse Practitioner 3173923489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61166688WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lummi Indian Business Council CurrentSince May 17, 2021 Accepting new patients
Lummi Indian Business Council CurrentSince May 17, 2021 Accepting new patients

Locations

2592 Kwina Rd
Bellingham, WA 98226
Phone (360) 312-2000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1598349235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269278",
            "telephone_number": "360-384-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "CAROLYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61166688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.