Jessica Nicole Mattingly, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3010918 Issued in KY

Practice address

7926 Preston Hwy Ste 106
Louisville, KY 40219-3848

Phone

(502) 964-4357

Fax

(502) 966-5948

NPI assigned

Dec 1, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brock Medical, LLC

  • Nurse Practitioner
  • London, KY
  • NPI 1023379815
  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762

  Family

  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Fast Pace Kentucky PLLC

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1669256913
  NPD
• Home Medical Visits, Inc

  • Clinic/Center
  • Holiday, FL
  • NPI 1639121080

  Family

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1255874731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 ANNA LEE DR",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400719083",
            "telephone_number": "502-216-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 PRESTON HWY STE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193848",
            "telephone_number": "502-964-4357",
            "fax_number": "502-966-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100495750",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7926 Preston Hwy Ste 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmattingly63478@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "7926 Preston Hwy Ste 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Courtney H Mattingly, MSOTR/L
• Darren Mattingly
• Douglas E Mattingly, M.D.
• Jason E Mattingly, MD
• Jessica Ann Mattingly, NURSE PRACTITIONER
• Jonathan Robert Mattingly
• Kristi Mattingly, APRN
• Lauren K Mattingly, PT
• Linda Mattingly
• Mary Mattingly

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.