Active NPI
Ann Louise Mattson, MD
- Gynecology Physician
- Boulder, CO
National Provider Identifier
1912085952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 31282
- Practice address
- 119 Ucb
Boulder, CO 80309-0119 - Phone
- (303) 492-2040
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 31282 | CO | Primary |
Addresses
Primary practice location
119 Ucb
Boulder, CO 80309-0119
Mailing address
3298 95TH St
Boulder, CO 80301-4930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01312826 | Medicaid | CO |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31282 | CO | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912085952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3298 95TH ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803014930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 UCB",
"city": "BOULDER",
"state": "CO",
"postal_code": "803090119",
"telephone_number": "303-492-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTSON",
"first_name": "ANN",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CO",
"license": "31282",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01312826",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
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.