Individual provider Active NPI

Matthew Noll, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1356914832
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3016271 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-3008
Phone
(859) 257-1000
Fax
(859) 323-1194
NPI assigned
Jul 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1156459 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3016271 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-3008

Mailing address

337 Jane Briggs Ave
Lexington, KY 40509-4502
Phone (937) 371-5859

Other practice location 1

310 S Limestone
Lexington, KY 40508-3008
Phone (937) 371-5859

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
I20211004002488 KY Practitioner - Nurse Practitioner 1951709062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1156459KYMDRegistered Nurse
3016271KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Oct 1, 2021 Accepting new patients

Locations

800 Rose St
#A
Lexington, KY 40536

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

Interoperability endpoints

  • Direct secure messaging: mnoll25528@ukhcdirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1356914832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 JANE BRIGGS AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405094502",
            "telephone_number": "937-371-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405363008",
            "telephone_number": "859-257-1000",
            "fax_number": "859-323-1194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 S Limestone",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405083008",
            "country_code": "US",
            "telephone_number": "937-371-5859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLL",
        "first_name": "MATTHEW",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1156459",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3016271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.