Active NPI
Mary Matherly
- Physician Assistant
- Mesa, AZ
National Provider Identifier
1598826174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3576
- Practice address
- 1066 N Power Rd
Ste. 101
Mesa, AZ 85205-5709 - Phone
- (480) 353-2200
- NPI assigned
- Dec 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3576 | AZ | Primary |
Addresses
Primary practice location
1066 N Power Rd
Ste. 101
Mesa, AZ 85205-5709
Mailing address
1440 S Val Vista Dr
#2093
Mesa, AZ 85204-6440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3576 | AZ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Phoenix Urgent Care LLC | Past | Accepting new patients | |
| Glendale Urgent Care LLC | Past | Accepting new patients | |
| Apache Junction Urgent Care LLC | Past | Accepting new patients | |
| Nextcare Arizona I JV LLC | Past | Accepting new patients | |
| Shea Urgent Care LLC | Past | Accepting new patients | |
| Avondale Urgent Care LLC | Past | Accepting new patients | |
| Casa Grande Urgent Care LLC | Past | Accepting new patients | |
| Pinnacle Medicine Inc. | Past | Accepting new patients | |
| Nextcare Arizona LLC | Past | Accepting new patients | |
| Thomas Road Urgent Care LLC | Past | Accepting new patients | |
| Greenway Urgent Care LLC | Past | Accepting new patients | |
| Dana Landing Urgent Care LLC | Past | Accepting new patients | |
| Desert Ridge Urgent Care LLC | Past | Accepting new patients | |
| Chandler Urgent Care LLC | Past | Accepting new patients | |
| Sun City Urgent Care LLC | Past | Accepting new patients |
Organizations & group practices 16
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.
-
dba Premier Emergency Medical Specialists
- Emergency Medicine Physician
- Chandler, AZ
- NPI 1104871961
-
dba NextCare
- Urgent Care Clinic/Center
- Apache Junction, AZ
- NPI 1053375659
-
- Urgent Care Clinic/Center
- Tempe, AZ
- NPI 1114798071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598826174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 S VAL VISTA DR",
"address_2": "#2093",
"city": "MESA",
"state": "AZ",
"postal_code": "852046440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1066 N POWER RD",
"address_2": "STE. 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852055709",
"telephone_number": "480-353-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHERLY",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "3576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.