Individual provider Active NPI

Matthew Keathley, DNP, FNP-C

  • Family Nurse Practitioner
  • Union City, TN
National Provider Identifier
1396581526
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36728 Issued in TN
Practice address
1109 E Reelfoot Ave
Union City, TN 38261-5856
Phone
(731) 599-9575
Fax
(731) 599-9576
NPI assigned
Jul 8, 2024
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 36728 TN Primary

Addresses

Primary practice location

1109 E Reelfoot Ave
Union City, TN 38261-5856

Mailing address

874 Union Ave RM 325
Memphis, TN 38103-3514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20241010000198 TN Practitioner - Nurse Practitioner 5193257509 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians
Stern Cardiovascular Foundation, IncGroup PAC ID 8123200540, 111 clinicians

Practice addresses (Care Compare)

1020 E Reelfoot Ave
Suite 201
Union City, TN 38261-5801
Phone (901) 271-1000

1109 E Reelfoot Ave
Suite a
Union City, TN 38261-5866
Phone (901) 271-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stern Cardiovascular Foundation, Inc CurrentSince Aug 1, 2024 Accepting new patients
Stern Cardiovascular Center, PA CurrentSince Jan 1, 2026 Accepting new patients

Locations

8060 Wolf River Blvd
Memphis, TN 38138
Phone (901) 271-2272

1020 E Reelfoot Ave
Ste 201
Union City, TN 38261

1109 E Reelfoot Ave
Ste A
Union City, TN 38261
Phone (731) 866-8441

Organizations & group practices 2

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 2

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1396581526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 UNION AVE RM 325",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615856",
            "telephone_number": "731-599-9575",
            "fax_number": "731-599-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATHLEY",
        "first_name": "MATTHEW",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.