Michelle Susan Mathison

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

731 Bielenberg Dr Ste 103-105
Woodbury, MN 55125-1700

Phone

(612) 800-8344

NPI assigned

Sep 2, 2021

Sex

Female

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)

Not enrolled

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1902574007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1996 COUNTY ROAD D E APT 223",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095372",
            "telephone_number": "651-353-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR STE 103-105",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "612-800-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHISON",
        "first_name": "MICHELLE",
        "middle_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rorra Charlotte Mast
• Peter M Matenaer, OTR/L
• Math and Science Academy
• Avinash Matha, DDS
• Angela Clare Matheson, M.S.CCC-SLP
• Matrxcare
• Christian Rich Matthews, MD
• Kathleen Mattson
• Lydia Ruth Mattson, MPH, RD
• Mary Lou Mattson, LCSW, DBTC

• Other Technician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Other Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.