Active NPI
Matthew D Stimson, CPED, CPOA, CFO
- Pedorthist
- La Follette, TN
National Provider Identifier
1942780580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pedorthist
- License
- PED109
- Practice address
- 2435 Jacksboro Pike Ste 3
La Follette, TN 37766-2912 - Phone
- (423) 449-8135
- NPI assigned
- Aug 14, 2018
- Last updated
- Aug 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | CFO03775 | TN | |
| Pedorthist | 224L00000X | PED109 | TN | Primary |
Addresses
Primary practice location
2435 Jacksboro Pike Ste 3
La Follette, TN 37766-2912
Mailing address
1708 Claire Stevens Cir
Knoxville, TN 37931-4552
Phone (865) 256-6288
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PED109 | TN | MD | Pedorthist |
| CFO03775 | TN | MD | Orthotic Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534204800000",
"number": "1942780580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1708 CLAIRE STEVENS CIR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379314552",
"telephone_number": "865-256-6288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2435 JACKSBORO PIKE STE 3",
"city": "LA FOLLETTE",
"state": "TN",
"postal_code": "377662912",
"telephone_number": "423-449-8135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIMSON",
"first_name": "MATTHEW",
"middle_name": "D",
"credential": "CPED, CPOA, CFO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-14",
"last_updated": "2018-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "TN",
"license": "CFO03775",
"primary": false
},
{
"code": "224L00000X",
"taxonomy_group": "",
"desc": "Pedorthist",
"state": "TN",
"license": "PED109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Follette, TN
- Brian Donald Sneck, DO
- Ann Raewyn Snodderly, PHARM D
- St. Mary's Medical Center of Campbell County, Inc.
- St. Mary's Medical Center of Campbell County, Inc.
- Barry A Stewart, MD
- Emily S Stiner, SP
- Janis K Stone
- Jason R Stooksbury, PT
- Brittany Sturgill, PTA
- Summit Medical Group, PLLC (Summit Medical Group of Campbell County)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.