Individual provider Active NPI

John M Matheny, RPH

  • Pharmacist
  • Lexington, SC
National Provider Identifier
1912050568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5000 Issued in SC
Practice address
348B Columbia Ave
Lexington, SC 29072-2657
Phone
(803) 957-5969
Fax
(803) 808-1829
NPI assigned
Jan 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5000 SC Primary

Addresses

Primary practice location

348B Columbia Ave
Lexington, SC 29072-2657

Mailing address

348B Columbia Ave
Lexington, SC 29072-2657
Phone (803) 957-5969

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
5000SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
M Corp Past Accepting new patients
Med Mart Lex Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912050568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348B COLUMBIA AVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722657",
            "telephone_number": "803-957-5969",
            "fax_number": "803-808-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348B COLUMBIA AVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722657",
            "telephone_number": "803-957-5969",
            "fax_number": "803-808-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "5000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.