Individual provider Active NPI

Jonathan Trevor Matthews, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1699242438
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138750 Issued in TX
Practice address
8101 S Broadway Ave
Tyler, TX 75703-5469
Phone
(903) 939-7500
Fax
(903) 939-7587
NPI assigned
Oct 30, 2018
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138750 TX Primary

Addresses

Primary practice location

8101 S Broadway Ave
Tyler, TX 75703-5469

Mailing address

8101 S Broadway Ave
Tyler, TX 75703-5469
Phone (903) 939-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20181228000467 TX Practitioner - Nurse Practitioner 2567707250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

3414 Golden Rd
Tyler, TX 75701-8336
Phone (903) 939-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138750TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

925 W Loop 281
Longview, TX 75604
Phone (430) 240-6029

305 W 20th St
Mt Pleasant, TX 75455
Phone (903) 572-2222

3414 Golden Rd
Tyler, TX 75701
Phone (903) 590-3050

8101 S Broadway Ave
Tyler, TX 75703
Phone (903) 525-3300

8101 S Broadway Ave
Ste 200
Tyler, TX 75703
Phone (903) 561-2495

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1699242438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035469",
            "telephone_number": "903-939-7500",
            "fax_number": "903-939-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035469",
            "telephone_number": "903-939-7500",
            "fax_number": "903-939-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "JONATHAN",
        "middle_name": "TREVOR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.