Matthew M Kershisnik, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

1831351205 Issued in UT

Practice address

1400 N 500 E
Logan, UT 84341-2455

Phone

(435) 716-5375

Fax

(843) 284-3401

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Anatomic Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Salt Lake City, UT
  • NPI 1558441485
  NPD (past)
• Hu Ding, M.D., P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Bountiful, UT
  • NPI 1740436625
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208649600000",
    "number": "1851363600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30309",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294170309",
            "telephone_number": "843-554-9300",
            "fax_number": "843-566-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412455",
            "telephone_number": "435-716-5375",
            "fax_number": "843-284-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHISNIK",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "1831351205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Kemp
• Samantha Kendall
• Keith Wesley Kent, DNP
• Jessica Kerby, CMHC
• Alexander Kern
• Ronda Kay Kershisnik
• Strawsee Lee Keyes
• Jeffrey S Keyser, MD
• David Kim
• Bryan C King, MD

• Anatomic Pathology & Clinical Pathology Physician in Logan, UT
• Providers in Logan, UT by specialty
• Anatomic Pathology & Clinical Pathology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.