Organization Active NPI

K.V. Mathew, M.D., P.C.

  • Psychiatry Physician
  • Flint, MI
National Provider Identifier
1992902613
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
KM033355 Issued in MI
Legal business name
K.V. MATHEW, M.D., P.C.
Practice address
4448 Oakbridge Dr Ste a
Flint, MI 48532-5484
Phone
(810) 230-7905
Fax
(810) 230-7908
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
K. V. Mathew, M.D.
Title
President
Phone
(810) 230-7905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X KM033355 MI Primary

Addresses

Primary practice location

4448 Oakbridge Dr Ste a
Flint, MI 48532-5484

Mailing address

4448 Oakbridge Dr Ste a
Flint, MI 48532-5484
Phone (810) 230-7905

Other identifiers 1

IdentifierTypeStateIssuer
1081980MedicaidMI

National Provider Directory

National Provider Directory

Locations

4448 Oakbridge Dr
Ste A
Flint, MI 48532
Phone (810) 230-7905

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992902613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4448 OAKBRIDGE DR STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325484",
            "telephone_number": "810-230-7905",
            "fax_number": "810-230-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4448 OAKBRIDGE DR STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325484",
            "telephone_number": "810-230-7905",
            "fax_number": "810-230-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K.V. MATHEW, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "K.",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-230-7905",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "KM033355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1081980",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.