Tanner Layne Mattison, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

L2451 Issued in TX

Practice address

2609 Sir Gawain LN
Lewisville, TX 75056-5719

Phone

(214) 392-5871

NPI assigned

Apr 7, 2006

Last updated

Apr 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mattison Pathology, L.L.P.

  • Anatomic Pathology & Clinical Pathology Physician
  • Edmond, OK
  • NPI 1912685686
  Medicare reassignment
• Mattison Pathology LLP

  • Clinical Medical Laboratory
  • Edmond, OK
  • NPI 1548034630
  NPD

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1881657245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 SIR GAWAIN LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565719",
            "telephone_number": "214-392-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 SIR GAWAIN LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565719",
            "telephone_number": "214-392-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "TANNER",
        "middle_name": "LAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L2451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49732-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2008-0818",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DR.0049728",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD.202224",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2008-02044",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42717",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L2451",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reena Mathew
• Shirley E Mathew, DDS, FAGD
• Jordan Mathews
• Clara Matimba
• Jarret Matta, PHD, APRN, CRNA
• Christy Mattox, COTA
• Maximus Care LLC
• Erin Maxwell, N.M.D.
• David C. May, M.D.
• Tiffany May, PA-C

• Anatomic Pathology & Clinical Pathology Physician in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Anatomic Pathology & Clinical Pathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.

Verify at the official NPI Registry.