Jeannie Maria Mattingly, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3007362 Issued in KY

Practice address

203 S Water St
Louisa, KY 41230-1347

Phone

(606) 649-2211

Fax

(606) 638-1399

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kiosk Medicine Kentucky LLCGroup PAC ID 6002887510, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeannie.mattingly@krogerhealth.eclinicaldirectplus.com

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.

• Kiosk Medicine Kentucky LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1205885035
  Medicare reassignment Care Compare group NPD
• Cleanslate Medical Group of Kentucky PLLC

  • Addiction Medicine (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1538600630
  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  • Family Nurse Practitioner
  • Franklin, KY
  • NPI 1457716706
  Medicare reassignment NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD
• Arc Health Systems, LLC

  • Psychiatric Hospital
  • Ashland, KY
  • NPI 1346922903
  NPD (past)
• Pioneer Health Group LLC

  • Addiction Medicine (Family Medicine) Physician
  • Louisa, KY
  • NPI 1235585126
  NPD (past)

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1326314824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 726",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412300726",
            "telephone_number": "606-638-0938",
            "fax_number": "859-813-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WATER ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301347",
            "telephone_number": "606-649-2211",
            "fax_number": "606-638-1399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2735 Bardstown Rd",
            "address_purpose": "LOCATION",
            "city": "St Catharine",
            "state": "KY",
            "postal_code": "400619435",
            "country_code": "US",
            "telephone_number": "606-638-0938",
            "fax_number": "859-813-5394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 S Main Cross St",
            "address_purpose": "LOCATION",
            "city": "Louisa",
            "state": "KY",
            "postal_code": "412301065",
            "country_code": "US",
            "telephone_number": "606-638-0938",
            "fax_number": "859-813-5394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Recovery Dr",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411018800",
            "country_code": "US",
            "telephone_number": "606-220-0010",
            "fax_number": "606-744-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "JEANNIE",
        "middle_name": "MARIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100233430",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaloni Victor Martinez, PSS
• Zachary Wayne Mason, PSS
• Quanikwa Massey
• Joshua Mata
• Brianna Matthews
• Rebecca Mae Mattingly, PSS
• Michelle Dawn Maupin, MSW, CSW, TCADC
• Max Medical Equipment, Inc.
• Leah Nicole May, APRN
• Paul Michael May, PSS

• Family Nurse Practitioner in Louisa, KY
• Providers in Louisa, 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 Dec 4, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.