Matthew Walker Fannell, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

P8468 Issued in TX

Practice address

2401 S 31St St
Temple, TX 76508-0001

Phone

(254) 724-5815

NPI assigned

May 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfannell14504@direct.sw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Dewitt Medical District

  • Emergency Medicine Physician
  • Cuero, TX
  • NPI 1366532608
  Medicare reassignment NPD
• Integrative Emergency Services Physician Group PA

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1285922542
  Medicare reassignment NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704

  Emergency Medicine

  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  NPD
• Dewitt Medical District

  • Skilled Nursing Facility
  • Katy, TX
  • NPI 1053511980
  NPD
• Dewitt Medical District

  • Rural Health Clinic/Center
  • Yorktown, TX
  • NPI 1821422551
  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796

  Emergency Medicine

  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • College Station, TX
  • NPI 1922061993

  Emergency Medicine

  NPD

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1790044683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNELL",
        "first_name": "MATTHEW",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P8468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfannell14504@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Nielsen Fan, MD/MPH
• Jerry Fan, MD
• Stacy Leigh Fancher, PT
• Hannah Fang, P.A.
• Yi Fang
• Brian Patrick Fanning, CRNA
• Marylisa Fanning
• Mary Theresa Fantazia, DNP
• Nishath Aliman Farhad, D.O.
• Debra A Fariss, MSCCC/SLP

• Emergency Medicine Physician in Temple, TX
• Providers in Temple, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.