Jamie Mathis, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

635 S Main St Ste B
Leitchfield, KY 42754-1056

Phone

(270) 287-0656

Fax

(270) 230-0328

NPI assigned

Jun 15, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Early Intervention and Consultation Services, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Leitchfield, KY
  • NPI 1780092957
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1609491653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 S MAIN ST STE B",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541056",
            "telephone_number": "270-287-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 S MAIN ST STE B",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541056",
            "telephone_number": "270-287-0656",
            "fax_number": "270-230-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "JAMIE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "RBT-20-123163",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Anthony Lyons, CRNA
• Rodney D Mann, CRNA
• Mantooth Physical Therapy, LLC
• Mary Vivian Mantooth, PT
• Veronica Sue Masden
• Amy Nicole Mattingly
• Angela Dawn McCray, P.T.
• Hannah Nicole McDowell
• Tyler Lee McGowen, BCBA, LBA
• Teresa Lynne McMonigal

• Behavior Technician in Leitchfield, KY
• Providers in Leitchfield, KY by specialty
• Behavior Technician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.