Active NPI
Julie A Mattingly, MS, CCS-SLP
- Speech-Language Pathologist
- Evansville, IN
National Provider Identifier
1316158686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2201205A
- Practice address
- 3700 Washington Ave
Evansville, IN 47750-0001 - Phone
- (812) 485-5603
- NPI assigned
- May 25, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2201205A | IN | Primary |
Addresses
Primary practice location
3700 Washington Ave
Evansville, IN 47750-0001
Mailing address
3700 Washington Ave
Evansville, IN 47750-0001
Phone (812) 485-5603
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2201205A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316158686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477500001",
"telephone_number": "812-485-5603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477500001",
"telephone_number": "812-485-5603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINGLY",
"first_name": "JULIE",
"middle_name": "A",
"credential": "MS, CCS-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "2201205A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.