Diana D Matlack, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

F000623 Issued in NY

Practice address

2495 Sawdust Rd Apt 1101
Spring, TX 77380-3365

Phone

(315) 216-6625

NPI assigned

Oct 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

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.

• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1922097187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 SAWDUST RD APT 1101",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SAWDUST RD APT 1101",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803365",
            "telephone_number": "315-216-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLACK",
        "first_name": "DIANA",
        "middle_name": "D",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "245276",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10039144",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "918024",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01793140",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maternal Child Health at Home LLC
• Michele Mathew
• Jeya Varkey Mathews, RPH
• Ferdnisha Mathieu
• Michelle Catherine Matiya, ED.S.
• Patricia S. Matocha, R.PH
• Swany Matos, MA
• Allyson Wesley Matteson, LCSW
• Matthew Kwong DMD PLLC
• Kaylee R Matthews

• Advanced Practice Midwife in Spring, TX
• Providers in Spring, TX by specialty
• Advanced Practice Midwife in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.