Active NPI
Kenneth Milton Mathews Jr., MD MSPH FACPM
- Public Health & General Preventive Medicine Physician
- Morristown, TN
National Provider Identifier
1841379609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- MD9700433NC
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140801001320 | TN | Order and Referring Only - Family Practice | 7719103472 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD012570TN | TN | MD | Emergency Medicine Physician |
| MD9700433NC | NC | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Public Health & General Preventive Medicine Physician
- Morristown, TN
- NPI 1750460515
Emergency Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.