Julianne Matteson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5334 Issued in ID

Practice address

8944 N Hess St Ste B
Hayden, ID 83835-9183

Phone

(208) 762-0251

Fax

(208) 762-0252

NPI assigned

Nov 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• North Star Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • Hayden, ID
  • NPI 1881938777
  NPD

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1982147153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12579 N AVONDALE LOOP",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357529",
            "telephone_number": "270-853-2570",
            "fax_number": "208-762-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8944 N HESS ST STE B",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359183",
            "telephone_number": "208-762-0251",
            "fax_number": "208-762-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "JULIANNE",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006972",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT5334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Hayden",
            "affiliation": "N",
            "address_1": "8944 N Hess St Ste B",
            "city": "Hayden",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838359183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aria Mangan
• Jared D Mangum, DC, MBA, LMT
• Gillian D. Maples, FNP
• Nichole Ashley Marleau, DPT
• Kevin Robert Marsh, D.C.
• Richard Joseph May, DC
• Raeann L McCart, LMT
• Cheri McCormack Fresh, LCPC
• Lauren Kristina McCrea, MS
• Dorothy Teresa McCree, NP

• All providers in Hayden, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.