MRS. TANIA M. MATTIOLI (NPI# 1396184362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396184362 |
| Entity Type | Individual |
| Full Name | MRS. TANIA M. MATTIOLI |
| Credential | NP |
| Practice Address |
190 Kimel Park Dr Ste 140 Winston Salem NC 27103-6946 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3362772225 |
| Practice Fax Number | 3362772231 |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2020-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209505 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5006244 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 Gateway Center Dr, Kernersville, NC 272842999 | 3369962173 | |
| 50 Miller St Ste I, Winston Salem, NC 271044206 | 3362772225 | 3362772231 |
| Street Address |
190 KIMEL PARK DR STE 140 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-6946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629074323 | Dennis George Leris | Physician Assistant | 190 Kimel Park Dr Ste 140, Winston Salem, NC 27103-6946 | 2005-06-27 |
| 1891307013 | Joyce Brunson-ollison | Registered Nurse | 190 Kimel Park Dr Ste 140, Winston Salem, NC 27103-6946 | 2020-08-19 |
| 1194199349 | Jake A Coffman | Physician Assistant | 190 Kimel Park Dr Ste 140, Winston Salem, NC 27103-6946 | 2015-11-25 |
| 1568808855 | Novant Medical Group, Inc | Physical Medicine & Rehabilitation | 190 Kimel Park Dr Ste 140, Winston Salem, NC 27103-6946 | 2013-05-14 |
| 1093789414 | Michael S Blau | Physician Assistant | 190 Kimel Park Dr Ste 140, Winston Salem, NC 27103-6946 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316567175 | Fenny Apondi Okello | Nurse Practitioner | 4254 Paula Dr, Winston Salem, NC 27127-6820 | 2020-04-22 |
| 1659917615 | Mh Medical Services, PC | Nurse Practitioner | 2415 S Stratford Rd Bldg 1, Winston Salem, NC 27103-6225 | 2019-11-25 |
| 1053957118 | Mh Medical Services, PC | Nurse Practitioner | 950 Reynolds Blvd Bldg 611-12, Winston Salem, NC 27105-3450 | 2019-11-25 |
| 1548756547 | Tracy Gaffney | Nurse Practitioner | 4134 Macarthur St, Winston Salem, NC 27107-6124 | 2018-07-03 |
| 1568958692 | Heather Triplett | Nurse Practitioner | Medical Center Blvd Neurosurgery Clinic, Winston Salem, NC 27157-0001 | 2018-07-01 |
| 1619498987 | Yolanda Enrich | Nurse Practitioner | 652 E Monmouth St, Winston Salem, NC 27107-3227 | 2017-06-27 |
| 1316483738 | Julie Shaun Kozel | Nurse Practitioner | 656 E Monmouth St, Winston Salem, NC 27107-3227 | 2017-01-09 |
| 1578923199 | Denise B Westendorf | Nurse Practitioner | 2680 Saint Johns Pl, Winston Salem, NC 27106-3830 | 2016-02-24 |
| 1568890705 | Lourdes C Ramos | Nurse Practitioner | 650 Highland Ave Ste 120, Winston Salem, NC 27101-4304 | 2013-10-25 |
| 1063735504 | Meredith Renae Clark | Nurse Practitioner | 605 Cotton St, Winston Salem, NC 27101-5080 | 2010-03-11 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on MRS. TANIA M. MATTIOLI.
| 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.