Organization Active NPI

Anita Mathur MD

  • Pediatrics Physician
  • Orange City, FL
National Provider Identifier
1790176766
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME67495 Issued in FL
Legal business name
ANITA MATHUR MD
Practice address
999 S Volusia Ave Ste B
Orange City, FL 32763-6564
Phone
(386) 774-7337
NPI assigned
Feb 12, 2015
Last updated
Feb 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Authorized official

Name
Lynette Tarnowski
Title
Billing Manager
Phone
(386) 774-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME67495 FL Primary

Addresses

Primary practice location

999 S Volusia Ave Ste B
Orange City, FL 32763-6564

Mailing address

999 S Volusia Ave Ste B
Orange City, FL 32763-6564
Phone (386) 774-7337

Other identifiers 2

IdentifierTypeStateIssuer
379425300MedicaidFL
37584OtherBCBS

National Provider Directory

National Provider Directory

Locations

999 S Volusia Ave
Ste B
Orange City, FL 32763
Phone (386) 774-7337

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1790176766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 S VOLUSIA AVE STE B",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636564",
            "telephone_number": "386-774-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S VOLUSIA AVE STE B",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636564",
            "telephone_number": "386-774-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANITA MATHUR MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "TARNOWSKI",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "386-774-7337"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME67495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379425300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37584",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.