Individual provider Active NPI

Almea M. Matanock, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Atlanta, GA
National Provider Identifier
1770727067
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
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

Updated by the provider on May 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.