Individual provider Active NPI

Courtney Laine Matyja, AU.D.

  • Audiologist
  • Conway, AR
National Provider Identifier
1962560995
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
284 Issued in AR
Practice address
855 S German LN Ste 2
Conway, AR 72034-6479
Phone
(501) 205-1215
Fax
(501) 205-1250
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1918 TN
Audiologist 231H00000X 284 AR Primary

Addresses

Primary practice location

855 S German LN Ste 2
Conway, AR 72034-6479

Mailing address

855 S German LN
Conway, AR 72034-6334
Phone (501) 205-1215

Other practice location 1

8000 Highway 107 Ste 1
Sherwood, AR 72120-5204
Phone (501) 819-0665

Other practice location 2

6401 Poplar Ave Ste 302
Memphis, TN 38119-4823
Phone (901) 726-0044

Other practice location 3

11219 Financial Centre Pkwy Ste 260
Little Rock, AR 72211-3882
Phone (501) 621-8250

Other names 1

  • Courtney L Wallis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060116000232 AR Practitioner - Qualified Audiologist 3971526211 Reassigns benefits to 1 organization
I20190130002313 TN Practitioner - Qualified Audiologist 3971526211 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1918TNMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Injoy Hearing LLC Audiologist Past Accepting new patients
Central Arkansas Hearing, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1962560995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S GERMAN LN",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346334",
            "telephone_number": "501-205-1215",
            "fax_number": "501-205-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S GERMAN LN STE 2",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346479",
            "telephone_number": "501-205-1215",
            "fax_number": "501-205-1250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8000 Highway 107 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Sherwood",
            "state": "AR",
            "postal_code": "721205204",
            "country_code": "US",
            "telephone_number": "501-819-0665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 Poplar Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194823",
            "country_code": "US",
            "telephone_number": "901-726-0044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11219 Financial Centre Pkwy Ste 260",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722113882",
            "country_code": "US",
            "telephone_number": "501-621-8250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATYJA",
        "first_name": "COURTNEY",
        "middle_name": "LAINE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "1918",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AR",
            "license": "284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "WALLIS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.