Active NPI
John T Mateyka, RPH
- Pharmacist
- Aitkin, MN
National Provider Identifier
1831282557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1146714
- Practice address
- 124 Minn Ave N
Aitkin, MN 56431 - Phone
- (218) 927-3754
- Fax
- (218) 927-6349
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1146714 | MN | Primary |
Addresses
Primary practice location
124 Minn Ave N
Aitkin, MN 56431
Mailing address
43277 335TH Lane
Aitkin, MN 56431
Phone (218) 927-3754
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1146714 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831282557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43277 335TH LANE",
"city": "AITKIN",
"state": "MN",
"postal_code": "56431",
"telephone_number": "218-927-3754",
"fax_number": "218-927-6349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 MINN AVE N",
"city": "AITKIN",
"state": "MN",
"postal_code": "56431",
"telephone_number": "218-927-3754",
"fax_number": "218-927-6349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEYKA",
"first_name": "JOHN",
"middle_name": "T",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "1146714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aitkin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.