MICHELLE F. MATTISON-KELLY M.D. NPI 1215048681

NPI Information

NPI: 1215048681
Provider Name: MICHELLE F. MATTISON-KELLY, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
6555 COYLE AVE
CARMICHAEL, CA
ZIP 95608
Phone: (916) 536-3520
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Michelle F. Mattison-kelly, M.D. is a pediatrics in Carmichael, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Michelle F. Mattison-kelly, M.D. NPI is 1215048681. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6555 COYLE AVE
CARMICHAEL, CA
ZIP 95608-302
Phone: (916) 536-3520

The enumeration date for this NPI number is 8/31/2006 and was last updated on 2/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		G75193	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G47345	MEDICARE UPIN	CALIFORNIA
2	00G751930	MEDICAID	CALIFORNIA
3	1969350	OTHER	CALIFORNIA	UNITED HEALTHCARE
4	000810807764	OTHER	CALIFORNIA	PHCS
5	1140767	OTHER	CALIFORNIA	CIGNA
6	7442156	OTHER	CALIFORNIA	AETNA
7	90079685	OTHER	CALIFORNIA	PACIFICARE
8	G75193	OTHER	CALIFORNIA	BLUE CROSS
9	053101	OTHER	CALIFORNIA	HEALTH NET
10	1055017	OTHER	CALIFORNIA	FIRST HEALTH
11	1091569	OTHER	CALIFORNIA	GREAT WEST
12	MCMG116700	OTHER	CALIFORNIA	WESTERN HEALTH ADVANTAGE
13	28799	OTHER	CALIFORNIA	INTERPLAN
14	00G751932	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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