Tyree Shirray Mathenia, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

212982 Issued in AR

Practice address

2200 Fort Roots Dr
North Little Rock, AR 72114-1709

Phone

(501) 257-1000

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1669024105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 NOTTINGHAM DR",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720233857",
            "telephone_number": "501-960-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT ROOTS DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721141709",
            "telephone_number": "501-257-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENIA",
        "first_name": "TYREE",
        "middle_name": "SHIRRAY",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R064774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "212982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Mason
• Magdaline Mason
• Taniya Sharrell Mason
• Kiandreia Yanice Massey
• Maternity Health Care Benefit Center, Inc.
• William Matheny
• Matheson Dialysis LLC
• Keithen Alex Mathis, MHPP
• Earl Matlock
• Megan N. Mattson

• Family Nurse Practitioner in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.