Lynnette M Matteson, NP
Individual provider Active NPI Nurse Practitioner · Petersburg, IN
NPI 1497124192 · NPPES record last updated Aug 15, 2016
Key facts
- NPI
- 1497124192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71005820A (IN)
- Practice address
- 611 E Main Street
Suite 110
Petersburg, IN 47567-1270 - Phone
- (812) 354-8426
- Fax
- (812) 354-9134
- NPI assigned
- Sep 23, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Karefirst Indiana PC
Newburgh Urgent Care LLC
Practice addresses (Care Compare)
313 Poplar St
Loogootee, IN 47553-2423
Phone (847) 235-6130
8211 W State Route 66 a
Newburgh, IN 47630-2534
Phone (812) 490-0463
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151013000040 | IN | Practitioner - Nurse Practitioner | 9931107141 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karefirst Indiana PC | Nurse Practitioner | Current |
Accepting new patients |
| Good Samaritan Hospital Physician Services, Inc | Nurse Practitioner | Current | Accepting new patients |
| Newburgh Urgent Care LLC | Nurse Practitioner | Current |
Accepting new patients |
| Theoria Medical | Nurse Practitioner | Current |
Accepting new patients |
| Gateway Urgent Care, LLC | Nurse Practitioner | Past |
Accepting new patients |
Locations
155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437
710 S Green River Rd
Ste 1
Evansville, IN 47715
Phone (812) 901-5780
607 W 6th St
Ste B
Jasper, IN 47546
Phone (812) 803-3775
12802 E US Highway 50
Loogootee, IN 47553
Phone (812) 295-2101
313 Poplar St
Loogootee, IN 47553
Phone (812) 295-4433
8211 W State Route 66
#A
Newburgh, IN 47630
Phone (270) 570-7500
520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280
1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064
3245 Mount Moriah Ave
Ste 10
Owensboro, KY 42303
Phone (270) 663-0955
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71005820A | IN | Yes |
Addresses
Primary practice location
611 E Main Street
Suite 110
Petersburg, IN 47567-1270
Mailing address
611 E Main St
Suite 110
Petersburg, IN 47567-1270
Phone (812) 354-8426
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201322180 | Medicaid | IN | |
| 000000984156 | Other | IN | ANTHEM |
Other providers in Petersburg, IN
- Gary J Keepes
- Mark A Luff
- Chastidy Mader
- Joseph Clayton Martin
- Toni M Martin
- Kelsey Marie Myers
- Rachael Pancake
- Pike County Area Rehabilitation Centers Inc
- Pike County Area Rehabilitation Centers Inc
- Pike County Area Rehabilitation Centers Inc
All providers in Petersburg, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.