Active NPI
Susan Mathis
- Case Manager/Care Coordinator
- West Hollywood, CA
National Provider Identifier
1689418394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 16070
- Practice address
- 7235 Santa Monica Blvd
West Hollywood, CA 90046-6724 - Phone
- (213) 584-4445
- NPI assigned
- Jun 19, 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 16070 | CA | Primary |
Addresses
Primary practice location
7235 Santa Monica Blvd
West Hollywood, CA 90046-6724
Mailing address
6872 Heffner Rd
Rocky Mount, NC 27803-8414
Phone (213) 375-8792
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 |
|---|---|---|---|
| 16070 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1689418394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6872 HEFFNER RD",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278038414",
"telephone_number": "213-375-8792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7235 SANTA MONICA BLVD",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900466724",
"telephone_number": "213-584-4445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-19",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "16070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.