Active NPI
Nanette Marie Matthews, PH.D.
- Clinical Psychologist
- Wausau, WI
National Provider Identifier
1790791606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1990-057
- Practice address
- 901 N. 6TH Street
Wausau, WI 54403 - Phone
- (715) 848-5022
- Fax
- (888) 778-6750
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1990-057 | WI | Primary |
Addresses
Primary practice location
901 N. 6TH Street
Wausau, WI 54403
Mailing address
901 N. 6TH Street
Wausau, WI 54403
Phone (715) 848-5022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1990-57 | Other | WI | STATE LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1790791606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 N. 6TH STREET",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54403",
"telephone_number": "715-848-5022",
"fax_number": "888-778-6750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N. 6TH STREET",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54403",
"telephone_number": "715-848-5022",
"fax_number": "888-778-6750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "NANETTE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1990-057",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1990-57",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.