Courtney Lynn Mattek, AGPCNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8509-33 Issued in WI

Practice address

112 E 5TH Ave
Antigo, WI 54409-2710

Phone

(715) 623-2331

NPI assigned

Jul 23, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: cmattek138087@direct.aspirus.org

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1982181913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 DERESCH ST",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544091175",
            "telephone_number": "651-428-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEK",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "credential": "AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8509-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Larson, CRNA
• Christina Leslie
• Devin Loomans, PT
• Gianna Losser, LMT
• Mark a. Aldrich, D.P.M., Inc.
• Christy Jean Mattern, PA-C
• Kristen M Mattmiller, RPH
• Joseph McCauslin, DO
• Carol L. McDougal, SLP
• Dennis S McFadden, DO

• Nurse Practitioner in Antigo, WI
• Providers in Antigo, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.

Verify at the official NPI Registry.