Individual provider Active NPI

Matthew Lawrence Tolleson, B.S.

  • Rehabilitation Practitioner
  • Henderson, NV
National Provider Identifier
1811206014
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2831 Saint Rose Pkwy
Suite 236
Henderson, NV 89052-4840
Phone
(702) 589-4869
Fax
(702) 589-4866
NPI assigned
Oct 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

2831 Saint Rose Pkwy
Suite 236
Henderson, NV 89052-4840

Mailing address

2831 Saint Rose Pkwy
Suite 236
Henderson, NV 89052-4840
Phone (702) 589-4869

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
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1811206014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 SAINT ROSE PKWY",
            "address_2": "SUITE 236",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524840",
            "telephone_number": "702-589-4869",
            "fax_number": "702-589-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 SAINT ROSE PKWY",
            "address_2": "SUITE 236",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524840",
            "telephone_number": "702-589-4869",
            "fax_number": "702-589-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLESON",
        "first_name": "MATTHEW",
        "middle_name": "LAWRENCE",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.