Matthew Standish, RN

Key facts

NPI

1801434212

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

95203039 (CA)

Practice address

785 18TH St
Arcata, CA 95521-5683

Phone

(707) 822-2481

Fax

(707) 822-3656

NPI assigned

Dec 16, 2019

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 2, 2020.

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1801434212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 8TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215770",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 18TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215683",
            "telephone_number": "707-822-2481",
            "fax_number": "707-822-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDISH",
        "first_name": "MATTHEW",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-16",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95203039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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