Individual provider Active NPI

Matthew Ryan Foulks, APRN-CNP

  • Acute Care Nurse Practitioner
  • Edgewood, KY
National Provider Identifier
1528741139
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.0033346 Issued in OH
Practice address
20 Medical Village Dr
Edgewood, KY 41017-5401
Phone
(859) 344-1512
Fax
(859) 331-3698
NPI assigned
Aug 10, 2023
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4007698 KY
Acute Care Nurse Practitioner 363LA2100X 1174274 KY
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0033346 OH Primary

Addresses

Primary practice location

20 Medical Village Dr
Edgewood, KY 41017-5401

Mailing address

4685 Forest Ave
Cincinnati, OH 45212-3397
Phone (513) 246-1964

Other practice location 1

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 865-1102

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
I20231026001264 KY Practitioner - Nurse Practitioner 4284080318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-7700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4007698KYMDNurse Practitioner
1174274KYMDAcute Care Nurse Practitioner
APRN.CNP.0033346OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Oct 29, 2023 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner CurrentSince Oct 29, 2023 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner Current Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Organizations & group practices 3

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 1

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1528741139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 FOREST AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123397",
            "telephone_number": "513-246-1964",
            "fax_number": "513-852-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175401",
            "telephone_number": "859-344-1512",
            "fax_number": "859-331-3698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10500 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424402",
            "country_code": "US",
            "telephone_number": "513-865-1102",
            "fax_number": "513-865-5552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOULKS",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4007698",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "1174274",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0033346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.