Individual provider Active NPI

Bertha Hettie Matheney, LPN

  • Licensed Practical Nurse
  • Lancaster, OH
National Provider Identifier
1801824271
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.090024 IV Issued in OH
Practice address
3700 Wilson Rd
Lancaster, OH 43130-8145
Phone
(740) 503-1360
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.090024 IV OH Primary

Addresses

Primary practice location

3700 Wilson Rd
Lancaster, OH 43130-8145

Mailing address

3700 Wilson Rd
Lancaster, OH 43130-8145
Phone (740) 503-1360

Other identifiers 1

IdentifierTypeStateIssuer
2476226MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
PN.090024 IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1801824271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WILSON RD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308145",
            "telephone_number": "740-503-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WILSON RD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308145",
            "telephone_number": "740-503-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENEY",
        "first_name": "BERTHA",
        "middle_name": "HETTIE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.090024  IV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2476226",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.