SUSAN LYNN MATTHEW (NPI# 1891031316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891031316 |
| Entity Type | Individual |
| Full Name | SUSAN LYNN MATTHEW |
| Credential | ANP |
| Practice Address |
855 Montgomery St Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8177350502 |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2017-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 559909 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
559909 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
559909 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 321912302 | 05 | |
| TX | 321912304 | 05 | |
| TX | BCBS | 8565NQ | 01 |
| TX | BCBS | 8574NM | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356313811 | Susan A Matthew | Nurse Practitioner | 7236 Jordan Drive Suite 101, Rapid City, SD 57701 | 2006-02-07 |
| 1417169095 | Susan Chacko Matthew | Registered Nurse | 500 Remington Blvd, Bolingbrook, IL 60440-4906 | 2007-05-04 |
| Street Address |
855 MONTGOMERY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310009 | Mercy Ngeusang | Nurse Practitioner | 5440 Tuxbury Pond Dr, Fort Worth, TX 76179-1489 | 2020-06-12 |
| 1003475682 | Rachel A Oyejide | Nurse Practitioner | 4205 Golden Horn Ln, Fort Worth, TX 76123-2569 | 2019-06-07 |
| 1457829962 | Nelius Njuguna | Nurse Practitioner | 5204 Bryant Irvin Rd Apt 2119, Fort Worth, TX 76132-3847 | 2018-11-02 |
| 1215442819 | Samuel Nganga Kamau | Nurse Practitioner | 10008 Channing Rd, Fort Worth, TX 76244-8500 | 2017-12-06 |
| 1841739018 | Shannon Boodhwani | Nurse Practitioner | 6100 Harris Pkwy Ste 345, Fort Worth, TX 76132-4134 | 2017-02-21 |
| 1831632306 | Brianna Hawkins | Nurse Practitioner | 10628 Donnis Dr, Fort Worth, TX 76244-6658 | 2016-11-30 |
| 1518359645 | Barbara Evans | Nurse Practitioner | 1001 12th Ave Ste 130, Fort Worth, TX 76104-3926 | 2015-02-26 |
| 1942575329 | Mari J. Finley | Nurse Practitioner | 4503 Anglin Cir, Fort Worth, TX 76140-4205 | 2012-03-18 |
| 1306110366 | Janice Renea Richardson | Nurse Practitioner | 1350 E Lancaster Ave Ste 100, Fort Worth, TX 76102-6671 | 2012-03-07 |
| 1477154490 | Cassandra Jade Hinojosa | Nurse Practitioner | 6301 Harris Pkwy Ste 300, Fort Worth, TX 76132-4266 | 2020-11-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on SUSAN LYNN MATTHEW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.