Kimberly Ann Mathis

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

8001 Beaty Grove Dr
Tampa, FL 33626-1602

Phone

(813) 926-5454

NPI assigned

Apr 22, 2020

Last updated

Apr 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Ann McDonnell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1790305423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 LAUREL AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342857832",
            "telephone_number": "941-441-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BEATY GROVE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261602",
            "telephone_number": "813-926-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Tampa",
            "affiliation": "N",
            "address_1": "8001 Beaty Grove Dr",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336261602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MCDONNELL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ricia J Mathew, ARNP
• Tiffani Mathew, MD
• Rachel Mathews, PHARMD
• Zubin Joseph Mathews
• Adam Mathias, PA-C
• Nicole Mathis, BA
• Janelle Mathisen
• Abhishek Mathur, MD
• Monal Patel Mathur, M.D.
• Rajneesh Mathur, DO

• Behavior Technician in Tampa, FL
• Providers in Tampa, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.