Katie Ellen Mathlin, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

0689 Issued in NH

Practice address

15 Rye St
Portsmouth, NH 03801-6829

Phone

(774) 282-0364

NPI assigned

Apr 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katie Ellen Ferguson Former name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Good Measures

  • Registered Dietitian
  • Boston, MA
  • NPI 1427487917

  KY

  Medicare reassignment

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1851745657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RYE ST",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038016829",
            "telephone_number": "774-282-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RYE ST",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038016829",
            "telephone_number": "774-282-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHLIN",
        "first_name": "KATIE",
        "middle_name": "ELLEN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "0689",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "LDN00898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "FERGUSON",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Beth Bloser, Licsw
• Mary Yost
• Talal Massad, M.D
• Corey R Mastin
• Krista Mastrogiacomo, PA-C
• Ayo Alexandra Matory, MD
• Naresh Matta, M.D.
• Brianna Matthews
• Johanna Mautz
• William Thomas Mautz, PHD

• Registered Dietitian in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Registered Dietitian in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.