Individual provider Active NPI

Matthew David Hathcock, MSN RN

  • Critical Care Medicine Registered Nurse
  • San Francisco, CA
National Provider Identifier
1790677714
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
95192399 Issued in CA
Practice address
690 Long Bridge St Apt 142
San Francisco, CA 94158-2395
Phone
(817) 240-2129
NPI assigned
Jul 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 846701 TX
Critical Care Medicine Registered Nurse 163WC0200X 95192399 CA Primary

Addresses

Primary practice location

690 Long Bridge St Apt 142
San Francisco, CA 94158-2395

Mailing address

690 Long Bridge St Apt 142
San Francisco, CA 94158-2395
Phone (817) 240-2129

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
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95192399CAMDCritical Care Medicine Registered Nurse
846701TXMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1790677714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 LONG BRIDGE ST APT 142",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582395",
            "telephone_number": "817-240-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 LONG BRIDGE ST APT 142",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582395",
            "telephone_number": "817-240-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHCOCK",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "MSN RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "846701",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95192399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.