CARRIE MATTOON (NPI# 1649245457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649245457 |
| Entity Type | Individual |
| Full Name | CARRIE MATTOON |
| Credential | P.A. |
| Practice Address |
120 Erie Canal Dr Suite 200 Rochester NY 14626-4607 |
| Mailing Address |
2031 State Route 96 Phelps NY 14532-9748 |
| Practice Telephone | 5852256680 |
| Practice Fax Number | 5852253472 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2010-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
007913 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
120 ERIE CANAL DR SUITE 200 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14626-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477528263 | Darushe Anissi | Acupuncturist | 120 Erie Canal Dr, Suite 200, Rochester, NY 14626-4607 | 2006-02-23 |
| 1790234722 | Ridgeway Physical Therapy and Chiropractic Pllc | Chiropractor | 120 Erie Canal Dr, Suite 130, Rochester, NY 14626-4607 | 2016-10-03 |
| 1013148154 | Shannon N Schiller | Physical Therapist | 120 Erie Canal Dr, Suite 310, Rochester, NY 14626-4607 | 2009-08-06 |
| 1720261415 | Jessica Haffey | Specialist | 120 Erie Canal Dr, Suite 310, Rochester, NY 14626-4607 | 2007-12-17 |
| 1306029087 | Sarah D Wait | Specialist | 120 Erie Canal Dr, Suite 310, Rochester, NY 14626-4607 | 2007-12-17 |
| 1790828531 | Todd Peterson | Physical Therapy Assistant | 120 Erie Canal Dr, Rochester, NY 14626-4607 | 2007-02-14 |
| 1487797288 | Melissa Ann Wilson | Specialist/Technologist | 120 Erie Canal Dr, Rochester, NY 14626-4607 | 2007-02-14 |
| 1164577805 | Gerald F Campo | Dentist | 120 Erie Canal Dr, Suite 150, Rochester, NY 14626-4607 | 2007-01-24 |
| 1871647388 | Micah Jeremy Sugarman | Chiropractor | 120 Erie Canal Dr, Suite 130, Rochester, NY 14626-4607 | 2007-01-22 |
| 1710941901 | Ridgewood Diagnostic Imaging | Radiology | 120 Erie Canal Dr, Rochester, NY 14626-4607 | 2006-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760978084 | Elizabeth M Neenan | Nurse Practitioner | 105 Canal Landing Blvd. Suite 1, Rochester, NY 14626 | 2018-07-10 |
| 1811488737 | Anthony Richard Mesolella | Dentist | 2081 W Ridge Rd Ste 204, Rochester, NY 14626 | 2018-05-26 |
| 1285157370 | Heather Kate Byam | Nurse Anesthetist, Certified Registered | 280 Mill Road, Rochester, NY 14626 | 2017-07-20 |
| 1710415039 | Abner O De Los Santos | Dentist | 120 Erie Canal Dr Ste 150, Rochester, NY 14626 | 2017-05-31 |
| 1609308709 | Ulfat Shafiq | Dentist | 1100 Long Pond Rd Ste 115, Greece, NY 14626 | 2017-03-29 |
| 1174982953 | S.a.v.o.c L.l.c | Preferred Provider Organization | 2833 West Ridge Road, Pearle Vision Ridgemont Plaza Suite 'a', Rochester, NY 14626 | 2016-02-22 |
| 1700244357 | Kerri Anne Sawyer | Registered Nurse | 82 Southridge Drive, Rochester, NY 14626 | 2016-02-10 |
| 1518398106 | Braces of Greece | Exclusive Provider Organization | 770 Fetzner Rd., Rochester, NY 14626 | 2013-12-06 |
| 1477983443 | Amy Pawlyk | Licensed Practical Nurse | 116 Annie Lane, Rochester, NY 14626 | 2013-11-12 |
| 1689911208 | Kathleen Zimmerman | Occupational Therapist | 1555 Long Pond Rd., 4th Floor, Rochester, NY 14626 | 2013-01-16 |
| Find all providers in zip 14626 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336396886 | Lucille Anne Coady | Nurse Practitioner | 909 Culver Rd, Rochester, NY 14609-7141 | 2008-08-26 |
| 1316090442 | Kelly Battoglia | Nurse Practitioner | 2824 Ridge Rd W, Rochester, NY 14626-1639 | 2007-01-20 |
| 1942267273 | Laurice Jackson | Nurse Practitioner | 40 Winter St, Rochester, NH 03867-3153 | 2006-04-28 |
| 1861568008 | Sylvia Farnand | Nurse Practitioner | 990 South Ave, Suite 104, Rochester, NY 14620 | 2006-11-28 |
| 1306918016 | Bernadette Strada | Nurse Practitioner | 990 South Ave, Rochester, NY 14620-2740 | 2006-11-15 |
| 1497838502 | Beverly Shaheen | Nurse Practitioner | 3101 Ridge Rd W, Building D, Rochester, NY 14626-3249 | 2006-10-23 |
| 1336222447 | Angela Ehlinger | Nurse Practitioner | 114 University Ave, Rochester, NY 14605-2929 | 2006-10-23 |
| 1104908391 | Corinne D Martin | Nurse Practitioner | 1555 Long Pond Rd, Dept. of Obstetrics and Gynecology, Rochester, NY 14626-4122 | 2006-10-19 |
| 1952336844 | Therese A Caffery | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2006-07-11 |
| 1144271214 | Katherine K Polino | Nurse Practitioner | 905 Culver Rd, Highland Community Ob Gyn, Rochester, NY 14609 | 2006-05-13 |
| Find all providers in ROCHESTER | ||||
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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.