Active NPI
Tina B. Mathews, RNFA
- Registered Nurse First Assistant
- Augusta, GA
National Provider Identifier
1811065253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- RN053784
- Practice address
- 426 Waverly Dr
Augusta, GA 30909-3121 - Phone
- (404) 290-3675
- NPI assigned
- Dec 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | RN053784 | GA | Primary |
| Perioperative Clinical Nurse Specialist | 364SP2800X | RN053784 | GA |
Addresses
Primary practice location
426 Waverly Dr
Augusta, GA 30909-3121
Mailing address
426 Waverly Dr
Augusta, GA 30909-3121
Phone (404) 290-3675
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN053784 | GA | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1811065253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 WAVERLY DR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309093121",
"telephone_number": "404-290-3675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 WAVERLY DR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309093121",
"telephone_number": "404-290-3675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "TINA",
"middle_name": "B.",
"name_prefix": "Ms.",
"credential": "RNFA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-02",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "GA",
"license": "RN053784",
"primary": true
},
{
"code": "364SP2800X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Perioperative",
"state": "GA",
"license": "RN053784",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.