Active NPI
John Paul Matthews, O.D.
- Optometrist
- San Angelo, TX
National Provider Identifier
1982647533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2739T
- Practice address
- 115 S Adams St
San Angelo, TX 76901-4101 - Phone
- (325) 653-2383
- Fax
- (325) 655-4783
- NPI assigned
- Jun 13, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2739T | TX | Primary |
Addresses
Primary practice location
115 S Adams St
San Angelo, TX 76901-4101
Mailing address
115 S Adams St
San Angelo, TX 76901-4101
Phone (325) 653-2383
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093287301 | Medicaid | TX | |
| 00E52J | Other | TX | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2739T | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982647533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 S ADAMS ST",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769014101",
"telephone_number": "325-653-2383",
"fax_number": "325-655-4783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 S ADAMS ST",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769014101",
"telephone_number": "325-653-2383",
"fax_number": "325-655-4783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "JOHN",
"middle_name": "PAUL",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2739T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "093287301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00E52J",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.