Active NPI
Matthew James Bokamper, MD
- Diagnostic Radiology Physician
- Memphis, TN
National Provider Identifier
1982390985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2023019897
- Practice address
- 6019 Walnut Grove Rd
Memphis, TN 38120-2113 - Phone
- (901) 226-3001
- NPI assigned
- Apr 12, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2023019897 | MO | Primary |
Addresses
Primary practice location
6019 Walnut Grove Rd
Memphis, TN 38120-2113
Mailing address
6019 Walnut Grove Rd
Memphis, TN 38120-2113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230608001168 | MO | Order and Referring Only - Diagnostic Radiology | 5698132595 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1982390985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6019 WALNUT GROVE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6019 WALNUT GROVE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202113",
"telephone_number": "901-226-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOKAMPER",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-12",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2023019897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.