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General NPI Number Information
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NPI Number | 1053294165
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Entity Type | Organization
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Legal Business Name | MATTER HEALTH OF NEW JERSEY LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 576 CENTRAL AVE FL 3
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City | EAST ORANGE
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State | NJ
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Zip | 07018-1951
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Country | US
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Telephone | 615-570-2330
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 4TH AVE S STE 210
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City | NASHVILLE
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State | TN
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Zip | 37210-2737
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Country | US
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Telephone | 615-570-2330
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | SEASON PENNINGTON
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Credential |
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Telephone | 615-570-2330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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