Active NPI
Willilam Patrick Mattingly, R.PH.
- Pharmacist
- Lebanon, KY
National Provider Identifier
1104079375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 007247
- Practice address
- 498 W Main St
Lebanon, KY 40033-1362 - Phone
- (270) 692-4950
- Fax
- (270) 692-2320
- NPI assigned
- Oct 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 007247 | KY | Primary |
Addresses
Primary practice location
498 W Main St
Lebanon, KY 40033-1362
Mailing address
498 W Main St
Lebanon, KY 40033-1362
Phone (270) 692-4950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007247 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pat'S Pharmacy, Inc. | Pharmacist | Past | Accepting new patients |
| Pat'S Pharmacy, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Lebanon, KY
- NPI 1295110526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251331200000",
"number": "1104079375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "498 W MAIN ST",
"city": "LEBANON",
"state": "KY",
"postal_code": "400331362",
"telephone_number": "270-692-4950",
"fax_number": "270-692-2320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 W MAIN ST",
"city": "LEBANON",
"state": "KY",
"postal_code": "400331362",
"telephone_number": "270-692-4950",
"fax_number": "270-692-2320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINGLY",
"first_name": "WILLILAM",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-31",
"last_updated": "2009-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "007247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.