Active NPI
Thaddeus Mattmiller, LCSW
- Social Worker
- Lexington, KY
National Provider Identifier
1821148438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1524
- Practice address
- 1101 Veterans Dr
Lexington, KY 40502-2235 - Phone
- (859) 233-4511
- Fax
- (859) 281-3867
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Social Worker | 104100000X | 1524 | KY | Primary |
Addresses
Primary practice location
1101 Veterans Dr
Lexington, KY 40502-2235
Mailing address
1101 Veterans Dr
Lexington, KY 40502-2235
Phone (859) 233-4511
Other practice location 1
257 Parkland Hts
Cynthiana, KY 41031-6017
Phone (859) 253-1686 ext. 520
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30615058 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Vista of the Bluegrass Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Stanton, KY
- NPI 1043250095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1821148438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 VETERANS DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405022235",
"telephone_number": "859-233-4511",
"fax_number": "859-281-3867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 VETERANS DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405022235",
"telephone_number": "859-233-4511",
"fax_number": "859-281-3867"
}
],
"practiceLocations": [
{
"address_1": "257 Parkland Hts",
"address_purpose": "LOCATION",
"city": "Cynthiana",
"state": "KY",
"postal_code": "410316017",
"country_code": "US",
"telephone_number": "859-253-1686 x520",
"fax_number": "859-254-2743",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATTMILLER",
"first_name": "THADDEUS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KY",
"license": "1524",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30615058",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.