MATTHEW DAVID RYNEARSON (NPI# 1114325511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114325511 |
| Entity Type | Individual |
| Full Name | MATTHEW DAVID RYNEARSON |
| Credential | PA |
| Practice Address |
3601 4th St Lubbock TX 79430-9406 |
| Mailing Address |
Po Box 5865 Lubbock TX 79408-5865 |
| Practice Telephone | 8067437337 |
| Practice Fax Number | 8067437329 |
| Mailing Telephone | 8067432898 |
| Mailing Fax Number | 8067432787 |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2016-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA09501 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3601 4TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430-9406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073516993 | Viviane Mamlok | Pathology | 3601 4th St, 1a115, Lubbock, TX 79430-0002 | 2005-05-24 |
| 1104436252 | Kanak N/a Parmar | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-08-04 |
| 1407465115 | Donald Wayne King Jr. | Nurse Anesthetist, Certified Registered | 3601 4th St, Lubbock, TX 79430-0002 | 2020-07-28 |
| 1588288674 | Hillary Powers | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-03 |
| 1215551692 | Amanda R Edinger | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-02 |
| 1487278966 | Daniel Elling Brown | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-6211 | 2020-06-01 |
| 1588288013 | Fabiana Monte Alegre Olmos Fernandez | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1154945574 | Alex Wilkins | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1720602253 | Amanda Lee Huggett | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1609490192 | Zeyad Saeed Amr Elharabi | Student in an Organized Health Care Education/Training Program | 3601 4th St, Department of Internal Medicine, Lubbock, TX 79430-0002 | 2020-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1891350310 | Erin Leigh Burton | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 | 2019-05-09 |
| 1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
| 1831683481 | Swagat Parajulee | Student in an Organized Health Care Education/Training Program | 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 | 2018-06-18 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1982144945 | Kazutaka Araki | Specialist/Technologist | 3601, 4th St, Lubbock, TX 79430 | 2017-02-24 |
| 1659725125 | Thomas Gregory Wyatt | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 3a122b, Lubbock, TX 79430 | 2016-04-20 |
| 1619391760 | Chinyere Mbagwu | General Practice | 3601 4th St # Ms 8143, Lubbock, TX 79430 | 2014-02-10 |
| 1982044111 | Eileen Mary Sprys | Family Medicine | 3601 4th St., Stop 8143, Lubbock, TX 79430 | 2013-07-02 |
| 1205196243 | Hilmi Alam | Family Medicine | Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 | 2012-05-24 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316294408 | Ronald Caporale | Physician Assistant | 1701 50th Street, Lubbock, TX 79412 | 2012-08-08 |
| 1699002675 | Jamie Fletcher | Physician Assistant | 5415 114th St, Lubbock, TX 79424 | 2009-11-11 |
| 1710160700 | Jessica Ferguson | Physician Assistant | 3606 21st St Ste 200, Lubbock, TX 79410-1225 | 2007-12-12 |
| 1104958560 | Janice Hallford Lampe | Physician Assistant | 6048 Marsha Sharp Fwy, Lubbock, TX 79407-3726 | 2007-03-12 |
| 1699819953 | Holly Jen Tyson | Physician Assistant | 3811 24th St, Lubbock, TX 79410-1813 | 2007-02-19 |
| 1154496974 | Kathleen Jo Marcum | Physician Assistant | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 | 2006-11-21 |
| 1336252220 | Gustavo Alonso Bendeck | Physician Assistant | 4010 22nd St, Lubbock, TX 79410-1116 | 2006-08-16 |
| 1316903875 | Kristina Lee | Physician Assistant | 3904 101st St, Lubbock, TX 79423-5725 | 2006-04-25 |
| 1467416636 | David Anthony King | Physician Assistant | 3514 21st Street, Lubbock, TX 79410 | 2006-04-14 |
| 1346246634 | Phyllis Rose Peterson | Physician Assistant | Ttuhsc Dept of Psychiatry, 3601 4th St., Ms 8103, Lubbock, TX 79430-8103 | 2005-06-22 |
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| 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.