Individual provider Active NPI

Morgan Nan Matter, RD, LD

  • Registered Dietitian
  • Saint Cloud, MN
National Provider Identifier
1629681119
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4355 Issued in MN
Practice address
1900 Centracare Cir Ste 2400
Saint Cloud, MN 56303-5000
Phone
(320) 229-4916
Fax
(320) 229-5174
NPI assigned
Aug 25, 2020
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 4355 MN Primary

Addresses

Primary practice location

1900 Centracare Cir Ste 2400
Saint Cloud, MN 56303-5000

Mailing address

1061 Wall St
Big Lake, MN 55309-9445
Phone (763) 496-9784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201023000050 MN Practitioner - Registered Dietitian Or Nutrition Professional 2264852698 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
Saint Cloud, MN 56303-2735

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

1900 Centracare Cir
Saint Cloud, MN 56303-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4355MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC CurrentSince Dec 13, 2020 Accepting new patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
St. Cloud Hospital CurrentSince Oct 1, 2020 Accepting new patients
Centracare Clinic CurrentSince Dec 13, 2020 Accepting new patients
Centracare Health System-NR LLC CurrentSince Dec 13, 2020 Accepting new patients
Centracare Clinic CurrentSince Dec 13, 2020 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
St. Cloud Hospital CurrentSince Oct 1, 2020 Accepting new patients
Centracare Clinic Past Accepting new patients
St Cloud Medical Group PA Past Accepting new patients

Locations

12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1900 Centracare Cir
Ste 2400
Saint Cloud, MN 56303
Phone (320) 229-4916

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Organizations & group practices 11

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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1629681119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 WALL ST",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099445",
            "telephone_number": "763-496-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 2400",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4916",
            "fax_number": "320-229-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTER",
        "first_name": "MORGAN",
        "middle_name": "NAN",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.