NPIMap

Organization Active NPI

Specialistsmat PSC

  • Addiction Medicine (Anesthesiology) Physician
  • Elizabethtown, KY
National Provider Identifier
1851998181
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X
Legal business name
SPECIALISTSMAT PSC
Practice address
110 Chase Way Ste 2
Elizabethtown, KY 42701-7827
Phone
(502) 212-0071
Fax
(502) 530-5303
NPI assigned
Oct 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Cara Nicole Netherton
Title
Practice Manager
Phone
(502) 212-0071

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Addiction Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LA0401X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

110 Chase Way Ste 2
Elizabethtown, KY 42701-7827

Mailing address

110 Chase Way Ste 2
Elizabethtown, KY 42701-7827
Phone (502) 212-0071

Other practice location 1

3310 Ruckriegel Pkwy
Jeffersontown, KY 40299-3764
Phone (502) 212-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201106001396 KY Part B Supplier - Clinic/Group Practice 7810307634 Receives reassigned benefits from 9 practitioners
Practice locations: Elizabethtown, KY; Louisville, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1851998181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CHASE WAY STE 2",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017827",
            "telephone_number": "502-212-0071",
            "fax_number": "502-996-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CHASE WAY STE 2",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017827",
            "telephone_number": "502-212-0071",
            "fax_number": "502-530-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3310 Ruckriegel Pkwy",
            "address_purpose": "LOCATION",
            "city": "Jeffersontown",
            "state": "KY",
            "postal_code": "402993764",
            "country_code": "US",
            "telephone_number": "502-212-0071",
            "fax_number": "502-996-8359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECIALISTSMAT PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "NETHERTON",
        "authorized_official_first_name": "CARA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "502-212-0071"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.