Individual provider Active NPI

Bert William Mathieson, ND,RD,LD,CDE

  • Naturopath
  • Bedford, NH
National Provider Identifier
1770508632
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
49 Issued in NH
Practice address
304 Riverway PL
Bedford, NH 03110-6764
Phone
(603) 623-6800
NPI assigned
Jul 13, 2006
Last updated
Nov 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 811007 NH
Naturopath 175F00000X 49 NH Primary

Addresses

Primary practice location

304 Riverway PL
Bedford, NH 03110-6764

Mailing address

304 Riverway PL
Bedford, NH 03110-6764
Phone (603) 623-6800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
811007NHMDRegistered Dietitian
49NHMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1770508632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 RIVERWAY PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106764",
            "telephone_number": "603-623-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 RIVERWAY PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106764",
            "telephone_number": "603-623-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIESON",
        "first_name": "BERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "ND,RD,LD,CDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "811007",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "NH",
            "license": "49",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.