Provider Demographics
NPI:1366257784
Name:MATRIX MEDICAL DATA PROCESSING LLC
Entity type:Organization
Organization Name:MATRIX MEDICAL DATA PROCESSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKELLY-LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-564-3627
Mailing Address - Street 1:20601 N 19TH AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3587
Mailing Address - Country:US
Mailing Address - Phone:877-564-3627
Mailing Address - Fax:
Practice Address - Street 1:20601 N 19TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3587
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty