Kourtney E Mattingly, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71006526A Issued in IN

Practice address

600 Mary St
Evansville, IN 47710

Phone

(812) 450-3201

Fax

(812) 450-4560

NPI assigned

Jul 7, 2016

Last updated

May 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Deaconess Hospital, Inc

  dba Deaconess Care Group

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443

  Nurse Practitioner

  Medicare reassignment NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Nurse Practitioner

  NPD
• Deaconess Clinic Inc.

  dba Deaconess Clinic II

  • Family Medicine Physician
  • Newburgh, IN
  • NPI 1033365986

  Nurse Practitioner

  NPD
• Deaconess Hospital Inc

  • Mental Health Counselor
  • Evansville, IN
  • NPI 1508723552

  Nurse Practitioner

  NPD
• Deaconess Hospital, Inc

  dba Deaconess Care Group Gateway

  • Hospitalist Physician
  • Newburgh, IN
  • NPI 1477592418

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Rural Health Clinic/Center
  • Petersburg, IN
  • NPI 1831345792

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1548612138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-3201",
            "fax_number": "812-450-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47710",
            "telephone_number": "812-450-3201",
            "fax_number": "812-450-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "KOURTNEY",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006526A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances E Matsel, PT
• Matthew 25 AIDS Services Inc (Matthew 25 Pharmacy)
• Haley Jo Matthews
• Theresa M Matthews
• Julie A Mattingly, MS, CCS-SLP
• Raquel Williams Mattingly
• Tabicia Linn Mattingly, APRN
• Lisa Mauck
• Dane Michael Maurer, DPT
• Holly Lynn Maurer, COTA

• Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.