Active NPI
Nathan David Matteson
- Behavior Technician
- Boise, ID
National Provider Identifier
1720885577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1087 E Park Blvd
Suite 100
Boise, ID 83712 - Phone
- (208) 369-9168
- NPI assigned
- Feb 28, 2025
- Last updated
- Feb 28, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | ID | Primary |
Addresses
Primary practice location
1087 E Park Blvd
Suite 100
Boise, ID 83712
Mailing address
10211 Cherry LN
Apt #302
Nampa, ID 83687
Phone (605) 520-9596
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740700800000",
"number": "1720885577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10211 CHERRY LN",
"address_2": "APT #302",
"city": "NAMPA",
"state": "ID",
"postal_code": "83687",
"telephone_number": "605-520-9596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1087 E PARK BLVD",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "83712",
"telephone_number": "208-369-9168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTESON",
"first_name": "NATHAN",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-28",
"last_updated": "2025-02-28",
"certification_date": "2025-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
- Gayle Matsumuro
- Stephanie Matta, PHARMD
- Victorie Dawn Mattei, LPC, CRC
- Matter and Spirit Counseling Services, LLC
- Brian D Matteson, M.D.
- Matthew D Pitcher, DO PLLC
- Matthew G. Fethke, D.D.S.,PC (High Desert Dental)
- Matthew R Sericati, M.D. Chartered
- Matthew S. Murphy (House of Hearing Audiology Clinic)
- Matthew Tuft Dental LLC (Copperstone Dental)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.