Rachel Carol Mathisen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20972 Issued in SC

Practice address

120 Louie St
Wagener, SC 29164-9445

Phone

(803) 564-8803

NPI assigned

May 11, 2017

Last updated

May 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Centre, AL
  • NPI 1932586476

  GA

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Rural Health Clinic/Center
  • Eufaula, AL
  • NPI 1588450316
  NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1679009724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 GREYSTONE SUMMIT DR",
            "address_2": "APT 308",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097541",
            "telephone_number": "732-533-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LOUIE ST",
            "city": "WAGENER",
            "state": "SC",
            "postal_code": "291649445",
            "telephone_number": "803-564-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHISEN",
        "first_name": "RACHEL",
        "middle_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Jackson, DC
• Virginia A Johnson, CNA
• Julian H. Fair 3Rd,DMD,PA
• Lawanda Legette, CNA
• Lexcaregivers LLC
• Rufus B. Antley, OD (Wagener Vision Clinic)
• Town of Wagener South Carolina
• Wagener Drug Co Inc (Wagener Drug Co)
• Mary C Ward, AGNP-BC

• Family Nurse Practitioner in Wagener, SC
• Providers in Wagener, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.

Verify at the official NPI Registry.