Individual provider Active NPI

Chandra Matthews, R.D., C.D.E.

  • Registered Dietitian
  • Santa Rosa, CA
National Provider Identifier
1952851016
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
721003 Issued in CA
Practice address
144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone
(707) 521-4511
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 721003 CA Primary

Addresses

Primary practice location

144 Stony Point Rd
Santa Rosa, CA 95401-4122

Mailing address

8036 Creekside Dr
Windsor, CA 95492-8754
Phone (707) 373-9504

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
721003CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Fay Nutrition Dietitian, Registered 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1952851016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8036 CREEKSIDE DR",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954928754",
            "telephone_number": "707-373-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014122",
            "telephone_number": "707-521-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "CHANDRA",
        "credential": "R.D., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "721003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.