Individual provider Active NPI

Benjamin Matzke, R.N.

  • Registered Nurse
  • Denver, CO
National Provider Identifier
1851661979
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
776308 Issued in TX
Practice address
723 30TH St
Denver, CO 80205-3037
Phone
(512) 671-0089
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 190294-5 MN
Registered Nurse 163W00000X 776308 TX Primary

Addresses

Primary practice location

723 30TH St
Denver, CO 80205-3037

Mailing address

723 30TH St
Denver, CO 80205-3037
Phone (512) 671-0089

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 Nurse

State licenses

LicenseStateTypeSpecialty
190294-5MNMDRegistered Nurse
776308TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1851661979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 30TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053037",
            "telephone_number": "512-671-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 30TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053037",
            "telephone_number": "512-671-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZKE",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "190294-5",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "776308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.