Active NPI
Matthew Johnson, PHARMD
- Compounded Sterile Preparations Pharmacist
- Altoona, PA
National Provider Identifier
1790073344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Compounded Sterile Preparations Pharmacist
- License
- RP455274
- Practice address
- 2907 Pleasant Valley Blvd
Altoona, PA 16602-4305 - Phone
- (814) 943-8164
- NPI assigned
- Jul 18, 2011
- Last updated
- Jul 3, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21976 | NC | |
| Pharmacist | 183500000X | 13382 | SC | |
| Compounded Sterile Preparations Pharmacist | 1835C0207X | RP455274 | PA | Primary |
Addresses
Primary practice location
2907 Pleasant Valley Blvd
Altoona, PA 16602-4305
Mailing address
928 Gold Hill Rd
Fort Mill, SC 29708-7947
Phone (803) 548-7197
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21976 | Other | NC | STATE LICENSE NUMBER |
| PH-13382 | Other | SC | STATE LICENSE NUMBER |
| RP455274 | Other | PA | STATE LICENSE NUMBER |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21976 | NC | MD | Pharmacist |
| 13382 | SC | MD | Pharmacist |
| RP455274 | PA | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751500800000",
"number": "1790073344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 GOLD HILL RD",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297087947",
"telephone_number": "803-548-7197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2907 PLEASANT VALLEY BLVD",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166024305",
"telephone_number": "814-943-8164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-18",
"last_updated": "2025-07-03",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "21976",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "13382",
"primary": false
},
{
"code": "1835C0207X",
"taxonomy_group": "",
"desc": "Pharmacist, Compounded Sterile Preparations",
"state": "PA",
"license": "RP455274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "21976",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "PH-13382",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "RP455274",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altoona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.