Amy Nicole Mattingly

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

106 Valleyview Dr
Leitchfield, KY 42754-7764

Phone

(270) 589-8156

NPI assigned

Nov 6, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Amy Nicole Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590796800000",
    "number": "1780838573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 VALLEYVIEW DR",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427547764",
            "telephone_number": "270-589-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 VALLEYVIEW DR",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427547764",
            "telephone_number": "270-589-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "AMY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2020-05-30",
        "certification_date": "2020-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "JOHNSON",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rodney D Mann, CRNA
• Mantooth Physical Therapy, LLC
• Mary Vivian Mantooth, PT
• Veronica Sue Masden
• Jamie Mathis, RBT
• Angela Dawn McCray, P.T.
• Hannah Nicole McDowell
• Tyler Lee McGowen, BCBA, LBA
• Teresa Lynne McMonigal
• Donald Ray Meers

• Developmental Therapist in Leitchfield, KY
• Providers in Leitchfield, KY by specialty
• Developmental Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.