Active NPI
Drae Dimattia
- Neonatal Intensive Care Registered Nurse
- River Oaks, TX
National Provider Identifier
1669291910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Intensive Care Registered Nurse
- License
- 150871
- Practice address
- 4916 Hope St
River Oaks, TX 76114-2949 - Phone
- (316) 322-5223
- NPI assigned
- Oct 4, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neonatal Intensive Care Registered Nurse | 163WN0002X | 150871 | KS | Primary |
Addresses
Primary practice location
4916 Hope St
River Oaks, TX 76114-2949
Mailing address
4916 Hope St
River Oaks, TX 76114-2949
Phone (316) 322-5223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150871 | KS | MD | Neonatal Intensive Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1669291910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4916 HOPE ST",
"city": "RIVER OAKS",
"state": "TX",
"postal_code": "761142949",
"telephone_number": "316-322-5223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4916 HOPE ST",
"city": "RIVER OAKS",
"state": "TX",
"postal_code": "761142949",
"telephone_number": "316-322-5223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMATTIA",
"first_name": "DRAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-04",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "KS",
"license": "150871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in River Oaks, TX
- Fawn Cox Florez, DC
- Crosspoint Autism Therapy
- CVS Pharmacy Inc (CVS Pharmacy # 07678)
- Katie Daley
- Brianna Demming
- Durell Management Services, L.L.C (Better Bodies Health Center)
- Durell Medical Services, P.L.L.C. (Better Bodies Health Center)
- Janet Elsa Finch, LCSW
- Meagan Fowler, RBT
- Mariah Jamie Fragoso
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.