MATTHEW WAYNE WOOLVERTON
NPI 1790250637
Nurse Anesthetist, Certified Registered in Colton, CA

Active since October 08, 2018
400 N PEPPER AVE, COLTON, CA 92324(909) 580-2400 Get Directions Write a Review

NPPES record last updated: August 12, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 12, 2021, Sep 16, 2019, Oct 8, 2018 (3 updates tracked since 2018).

About Matthew Wayne Woolverton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW WAYNE WOOLVERTON (NPI 1790250637) is an individual nurse anesthetist, certified registered in Colton, California, licensed in California (95001087) and active in the NPI registry since October 2018. He is a graduate of Other (2018).

NPPES Registry Identity

NPI1790250637
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMATTHEW WAYNE WOOLVERTON
Location Address400 N PEPPER AVEColton, CA 92324-1819
Mailing AddressPo Box 34120Reno, NV 89533-4120 · (775) 747-5050 · Fax (775) 747-5005
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateOctober 8, 2018
Last NPPES UpdateAugust 12, 20213 updates tracked since enumeration
NPPES CertifiedAugust 12, 2021
NPI 1790250637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in CA · 95001087
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered NurseTaxonomy 163W00000X · License 790267 (CA)
400 N PEPPER AVE, Colton, CA 92324

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Matthew Wayne Woolverton is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4284975103
PECOS Enrollment IDI20190402002654

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Neurological Surgery
400 N PEPPER AVE, 3RD FLOOR
COLTON, CA 92324
Nurse Practitioner (Family)
400 N PEPPER AVE
COLTON, CA 92324
Internal Medicine (Pulmonary Disease)
400 N PEPPER AVE
COLTON, CA 92324
Internal Medicine
400 N PEPPER AVE
COLTON, CA 92324
Internal Medicine
400 N PEPPER AVE
COLTON, CA 92324
Internal Medicine
400 N PEPPER AVE
COLTON, CA 92324
Internal Medicine
400 N PEPPER AVE
COLTON, CA 92324
Emergency Medicine
400 N PEPPER AVE
COLTON, CA 92324

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Woolverton's NPI number?

The NPI number for Matthew Woolverton is 1790250637. It was assigned to this individual provider in the NPPES registry on October 8, 2018.

Where is Matthew Woolverton located?

Matthew Woolverton practices at 400 N Pepper Ave, Colton, CA 92324. The listed phone number is (909) 580-2400.

What is Matthew Woolverton's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Matthew Woolverton enrolled in Medicare?

Yes. Matthew Woolverton is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Matthew Woolverton was last updated on August 12, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.