Individual provider Active NPI

Charles Mitchell Matkin, DC

  • Chiropractor
  • Mt Pleasant, TX
National Provider Identifier
1699705608
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC2841 Issued in TX
Practice address
727 E Furguson Rd
Mt Pleasant, TX 75455
Phone
(903) 572-0212
Fax
(903) 572-5321
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

727 E Ferguson Rd
Mt Pleasant, TX 75455-5428
Phone (903) 572-0212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110510000431 TX Practitioner - Chiropractic 3476739350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC2841TXMDChiropractor
000000TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matkin Chiropractic Office Inc Chiropractor CurrentSince May 1, 2011 Accepting new patients

Locations

727 E Ferguson Rd
Mt Pleasant, TX 75455
Phone (214) 572-0212

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC2841 TX Primary

Addresses

Primary practice location

727 E Furguson Rd
Mt Pleasant, TX 75455

Mailing address

PO Box 1103
727 East Ferguson Rd
Mt Pleasant, TX 75455
Phone (903) 572-0212

Other identifiers 1

IdentifierTypeStateIssuer
001144701MedicaidTX

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1699705608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1103",
            "address_2": "727 EAST FERGUSON RD",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "75455",
            "telephone_number": "903-572-0212",
            "fax_number": "903-572-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 E FURGUSON RD",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "75455",
            "telephone_number": "903-572-0212",
            "fax_number": "903-572-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATKIN",
        "first_name": "CHARLES",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC2841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001144701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.