Individual provider Active NPI

Kenneth Milton Mathews Jr., MD MSPH FACPM

  • Public Health & General Preventive Medicine Physician
  • Morristown, TN
National Provider Identifier
1841379609
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD9700433NC Issued in NC
Practice address
812 West 4TH North St
Morristown, TN 37814
Phone
(423) 581-3490
Fax
(423) 581-0657
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD012570TN TN
Emergency Medicine Physician 207P00000X MD9700433NC NC
Family Medicine Physician 207Q00000X MD012570TN TN
Family Medicine Physician 207Q00000X MD9700433NC NC
Internal Medicine Physician 207R00000X MD012570TN TN
Internal Medicine Physician 207R00000X MD9700433NC NC
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X MD012570TN TN
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X MD9700433NC NC
Public Health & General Preventive Medicine Physician 2083P0901X MD012570TN TN
Public Health & General Preventive Medicine Physician 2083P0901X MD9700433NC NC Primary
General Practice Physician 208D00000X MD012570TN TN
General Practice Physician 208D00000X MD9700433NC NC

Addresses

Primary practice location

812 West 4TH North St
Morristown, TN 37814

Mailing address

812 West 4TH North St
Morristown, TN 37814
Phone (423) 581-3490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140801001320 TN Order and Referring Only - Family PracticePractitioner - General SurgeryPractitioner - Family Practice 7719103472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD012570TNTNMDEmergency Medicine Physician
MD9700433NCNCMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Mathews Jr MD PC Emergency Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1841379609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 WEST 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "37814",
            "telephone_number": "423-581-3490",
            "fax_number": "423-581-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 WEST 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "37814",
            "telephone_number": "423-581-3490",
            "fax_number": "423-581-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "KENNETH",
        "middle_name": "MILTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD MSPH FACPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD012570TN",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "MD9700433NC",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD012570TN",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "MD9700433NC",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD012570TN",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "MD9700433NC",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "TN",
            "license": "MD012570TN",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NC",
            "license": "MD9700433NC",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TN",
            "license": "MD012570TN",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NC",
            "license": "MD9700433NC",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD012570TN",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "MD9700433NC",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.