Individual provider Active NPI

Trina R. Mattingly, APRN

  • Pediatric Nurse Practitioner
  • Berea, KY
National Provider Identifier
1316993165
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3003803 Issued in KY
Practice address
305 Estill St FL 4
Berea, KY 40403-1742
Phone
(859) 986-2343
Fax
(859) 986-2344
NPI assigned
May 25, 2006
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3003803 KY Primary

Addresses

Primary practice location

305 Estill St FL 4
Berea, KY 40403-1742

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other identifiers 3

IdentifierTypeStateIssuer
78901261MedicaidKY
6400OtherKYGROUP MEDICARE #
78009297MedicaidKY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040216000406 KY Practitioner - Nurse Practitioner 8022903566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Health System IncGroup PAC ID 4183641400, 37 clinicians

Practice addresses (Care Compare)

305 Estill St
Berea, KY 40403-1742
Phone (859) 986-2343

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3003803KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Saint Joseph Health System, Inc. CurrentSince Apr 3, 2017 Accepting new patients
Neurosurgical Associates PSC Current Accepting new patients
Saint Joseph Health System, Inc. CurrentSince Apr 3, 2017 Accepting new patients
Saint Joseph Health System, Inc. Current Accepting new patients
Saint Joseph Health System, Inc. Past Accepting new patients
Herbert W Long Past Accepting new patients
Saint Joseph Health Inc Past Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

305 Estill St
Fl 4
Berea, KY 40403
Phone (859) 986-2343

417 River Dr
Irvine, KY 40336
Phone (606) 723-0399

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

1401 Harrodsburg Rd
Ste B370
Lexington, KY 40504
Phone (859) 313-3319

701 Bob O Link Dr
Ste 100
Lexington, KY 40504
Phone (859) 224-3194

701 Bob O Link Dr
Ste 120
Lexington, KY 40504
Phone (859) 277-3137

100 E Liberty St
Ste 800
Louisville, KY 40202
Phone (502) 540-3339

200 Rice St
Wilmore, KY 40390
Phone (859) 858-9355

475 Shoppers Dr
Winchester, KY 40391
Phone (859) 737-2783

Interoperability endpoints

  • Direct secure messaging: tmattingly274730@direct.stlukeshealth.org
  • Direct secure messaging: trinamattingly@kysjhspe.allscriptsdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1316993165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST FL 4",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-986-2343",
            "fax_number": "859-986-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "TRINA",
        "middle_name": "R.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3003803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78901261",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE #",
            "identifier": "6400",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78009297",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.