KIM MATTERN (NPI# 1619395407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619395407 |
| Entity Type | Individual |
| Full Name | KIM MATTERN |
| Practice Address |
1105 Parkerplum Dr Bismarck ND 58503-8847 |
| Practice Telephone | 7012585395 |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2014-03-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835N1003X |
Pharmacist Specialization: Nutrition Support |
4077 | ND | Pharmacy Service Providers |
| Street Address |
1105 PARKERPLUM DR |
| City | BISMARCK |
| State | ND |
| Zip Code | 58503-8847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951503 | Community Options for Residential and Employment Services, Inc | Community/Behavioral Health | 4909 Shelburne St, Bismarck, ND 58503 | 2020-08-03 |
| 1104460476 | Brittany Lee Feil | Registered Nurse | 808 N Washington St., Bismarck, ND 58503 | 2019-10-30 |
| 1760030670 | Rachel Lees | Technician | 1727 Valley Drive, Bismark, ND 58503 | 2019-09-04 |
| 1700444619 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 807 East Main Suite A, Bismarck, ND 58503 | 2019-06-05 |
| 1881162972 | White Drug Co of Jamestown Inc | Pharmacy | 900 Ne 43rd Ave, Bismarck, ND 58503 | 2018-11-06 |
| 1104347137 | Adapt, Inc. | Counselor | 1720 Burnt Boat Drive, Suite 108, Bismarck, ND 58503 | 2017-06-29 |
| 1679010953 | Optimum Therapies of North Dakota, Inc | Physical Therapist | 4204 Boulder Ridge Rd, Suite 100, Bismarck, ND 58503 | 2017-01-25 |
| 1972954162 | Ava Burckhard | Speech-Language Pathologist | 4501 Coleman St N Suite #103, Pediatric Therapy Partners, Bismarck, ND 58503 | 2016-06-29 |
| 1306292842 | Margaret Williams | Nurse Practitioner | 4315 Ottawa St, Bismarck, ND 58503 | 2016-05-13 |
| 1649638958 | Horizon Chiropractic & Wellness PC | Chiropractor | 4535 Northern Sky Dr., Bismarck, ND 58503 | 2016-02-01 |
| Find all providers in zip 58503 | ||||
| Taxonomy Code | 1835N1003X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Nutrition Support |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972722775 | Daniel Peter Mcpherson | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2007-04-24 |
Please comment or provide details below to improve the information on KIM MATTERN.
| 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.