Angela D Matthiessen, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5534 Issued in SC

Practice address

402 Dogwood Dr S
Murrells Inlet, SC 29576-8025

Phone

(770) 330-1061

NPI assigned

Oct 9, 2009

Last updated

Feb 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Creatability Inc

  • Occupational Therapist
  • Murrells Inlet, SC
  • NPI 1255001582
  NPD Authorized official

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1669707568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 DOGWOOD DR S",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295768025",
            "telephone_number": "770-330-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DOGWOOD DR S",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295768025",
            "telephone_number": "770-330-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHIESSEN",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OY002294",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "5534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "008454699",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MURRELLSINLET",
            "affiliation": "N",
            "address_1": "402 Dogwood Dr S",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295768025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Renee Maselli, MD
• Audrey Cheryl Massie, APRN
• Ryan Michael Mathern, MD
• Kirsi Mathews, PHARMD
• Alyssa Marie Matthiessen, LPC
• Reynaldo Matute, M.D.
• Jerome F McCabe, MD
• Michael McCaffrey, M.D.
• Joshua Donald McCaslin
• Debra Michelle McCauley, DO

• Occupational Therapist in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.