Doreen Mattimiro, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024091068 Issued in VA

Practice address

19415 Deerfield Ave
Suite 213
Lansdowne, VA 20176-8452

Phone

(703) 729-9220

Fax

(703) 858-3529

NPI assigned

Jan 18, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: doreenmattimiro@asimp.allscriptsdirect.net

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1932252673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE",
            "address_2": "SUITE 213",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768452",
            "telephone_number": "703-729-9220",
            "fax_number": "703-858-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE",
            "address_2": "SUITE 213",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768452",
            "telephone_number": "703-729-9220",
            "fax_number": "703-858-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIMIRO",
        "first_name": "DOREEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024091068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010108276",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cinthia Lyvers, FNP
• Barry R Maharaj, DDS
• Qudsia Iqbal Malik, M.D.
• Tara Mangat, MD
• Vinod Mathew
• Julie Fischer McCarter, LCSW
• McDonald Pediatrics PC
• Cynthia McFarland
• Sarah R McQueen, MD
• Elaine Marie Mehlberg, SLP

• Family Nurse Practitioner in Lansdowne, VA
• Providers in Lansdowne, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.