Mattie Morgan Whitehead

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0004103 Issued in NU

Practice address

5115 Clay St
Denver, CO 80221-1223

Phone

(903) 277-9835

NPI assigned

Mar 11, 2021

Last updated

Mar 11, 2021By 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 2

Addresses

Other identifiers 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.

• Physician's Therapy Group, LLC

  • Speech-Language Pathologist
  • Springdale, AR
  • NPI 1144276585
  NPD (past)
• Vivo Sano Kids

  dba All About Kids Therapy Center

  • Speech-Language Pathologist
  • Springdale, AR
  • NPI 1023405420
  NPD (past)

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1700461613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 CLAY ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802211223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 CLAY ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802211223",
            "telephone_number": "903-277-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "MATTIE",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "0001403",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": "0004103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001403",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Dinah White, MD
• Shawn David White, MA, CCC-SLP
• Tatiana White, PT, DPT
• Timber Eileen White, LMSW
• Jason Comer Whitehead, M.DIV, M.S.W.
• Amy Whitehorn, RDH
• Bethany Whitehorn, PA-C
• Megan Bendik Whitehouse, FNP-C
• Ann Whiteley, NP
• Jon Lawrence Whiteley, DDS

• Occupational Therapy Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Occupational Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.