Individual provider Active NPI

Cherlyn Mitzi Matthews, NP-C

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1871634113
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN118570 Issued in GA
Practice address
400 Poplar St
Macon, GA 31201-3336
Phone
(478) 787-4266
Fax
(478) 787-4199
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN118570 GA Primary

Addresses

Primary practice location

400 Poplar St
Macon, GA 31201-3336

Mailing address

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490
Phone (478) 301-2362

Other identifiers 1

IdentifierTypeStateIssuer
RN118570OtherGAAPRN LICENSE NUMBER

Other names 1

  • Mitzi Matthews Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070417000185 GA Practitioner - Nurse Practitioner 3577668730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN118570GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Corporation of Mercer University CurrentSince Jul 5, 2022 Accepting new patients
The Corporation of Mercer University CurrentSince Jul 5, 2022 Accepting new patients
First Choice Primary Care, Inc. Past Accepting new patients
Senior Psych Solutions Corp Past Accepting new patients
First Choice Primary Care, Inc. Past Accepting new patients
Cornerstone Medical Assoc., LLC Past Accepting new patients

Locations

250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362

1550 College St
Macon, GA 31207
Phone (478) 301-2600

Interoperability endpoints

  • Direct secure messaging: georgiabehavioralhealthprofessionals.cherlynmatthews@124220.advancedmd-direct.com
  • FHIR API: https://api.platform.athenahealth.com/25178/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1871634113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490",
            "telephone_number": "478-301-2362",
            "fax_number": "478-301-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 POPLAR ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013336",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "CHERLYN",
        "middle_name": "MITZI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN118570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "RN118570",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITZI",
            "last_name": "MATTHEWS",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.