Active NPI
Almea M. Matanock, M.D.
- Student in an Organized Health Care Education/Training Program
- Atlanta, GA
National Provider Identifier
1770727067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1600 Clifton Rd NE
Ms a 38
Atlanta, GA 30329-4018 - Phone
- (404) 819-9834
- NPI assigned
- Apr 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101252122 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | Primary |
Addresses
Primary practice location
1600 Clifton Rd NE
Ms a 38
Atlanta, GA 30329-4018
Mailing address
1264 N Morningside Dr NE
Apt B
Atlanta, GA 30306-3335
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431302400000",
"number": "1770727067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1264 N MORNINGSIDE DR NE",
"address_2": "APT B",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303063335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CLIFTON RD NE",
"address_2": "MS A 38",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303294018",
"telephone_number": "404-819-9834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATANOCK",
"first_name": "ALMEA",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-30",
"last_updated": "2015-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101252122",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.