Individual provider Active NPI

Samuel Coleman Matheny, MD

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1932137478
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14812 Issued in KY
Practice address
740 South Limestone
Lexington, KY 40536-0001
Phone
(859) 323-6711
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14812 KY Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 14812 KY
Addiction Medicine (Family Medicine) Physician 207QA0401X 14812 KY
Adult Medicine Physician 207QA0505X 14812 KY
Geriatric Medicine (Family Medicine) Physician 207QG0300X 14812 KY
Sports Medicine (Family Medicine) Physician 207QS0010X 14812 KY

Addresses

Primary practice location

740 South Limestone
Lexington, KY 40536-0001

Mailing address

2333 Alumni Park PLZ
Suite 200
Lexington, KY 40517-4012
Phone (859) 257-7910

Other identifiers 1

IdentifierTypeStateIssuer
64148125MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041102000705 KY Practitioner - Family PracticePractitioner - Preventive Medicine 0042272973 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14812KYMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Family Medicine CurrentSince Jan 1, 1997 Accepting new patients

Locations

750 Morton Blvd
Hazard, KY 41701
Phone (606) 439-1559

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

217 Elm Tree Ln
Lexington, KY 40507
Phone (859) 257-8801

2333 Alumni Park Plz
Ste 200
Lexington, KY 40517

Interoperability endpoints

  • Direct secure messaging: smatheny33492@ukhcdirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1932137478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ALUMNI PARK PLZ",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174012",
            "telephone_number": "859-257-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 SOUTH LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "SAMUEL",
        "middle_name": "COLEMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "14812",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "KY",
            "license": "14812",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "14812",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "KY",
            "license": "14812",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "KY",
            "license": "14812",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KY",
            "license": "14812",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64148125",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.