PETER JOSEPH MATTINGLY (NPI# 1306299813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306299813 |
| Entity Type | Individual |
| Full Name | PETER JOSEPH MATTINGLY |
| Credential | M.D. |
| Practice Address |
300 East Hospital Road Dwight David Eisenhower Army Medical Center Fort Gordon GA 30905-5650 |
| Mailing Address |
300 W Hospital Rd Fort Gordon GA 30905-5741 |
| Practice Telephone | 7067874657 |
| Mailing Telephone | 7067874657 |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2018-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 079520 | GA | Student, Health Care |
| Street Address |
300 EAST HOSPITAL ROAD DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083613665 | Joseph Melton Bird | Social Worker | 300 East Hospital Road, Room 13a-10, Fort Gordon, GA 30905-5650 | 2005-07-18 |
| 1023616224 | Vernon Thomas Traeder Sharp | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-10-12 |
| 1740894583 | Stephanie Marie Rice | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905 | 2020-08-31 |
| 1710590542 | Kenneth Blind | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-08-31 |
| 1467078519 | Joseph Nathaniel Stancampiano | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30509-5650 | 2020-06-24 |
| 1912523101 | Austin Keith Nokes | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-23 |
| 1992329940 | Eda Chen | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-05 |
| 1154945269 | Yiwei Jiao | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-04 |
| 1942824164 | Camille Lynn | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-03 |
| 1023632429 | Brandon Lee Myers | Student in an Organized Health Care Education/Training Program | 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230387 | William Edward Bane | Student in an Organized Health Care Education/Training Program | 320 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-23 |
| 1972125763 | Mark Edward Gartner | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Dwight D. Eisenhower Army, Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-05-14 |
| 1184284598 | Nicholas James Carlin | Student in an Organized Health Care Education/Training Program | Medicine, Dwight David Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2019-06-18 |
| 1700446341 | Nicholas John Carter | Student in an Organized Health Care Education/Training Program | Eisenhower Army Medical Center Gme, 300 E. Hospital Rd, Fort Gordon, GA 30905-5650 | 2019-06-17 |
| 1306405931 | Kevin Ryan Patrick | Student in an Organized Health Care Education/Training Program | Interserive Physician Assitant Program, 300 East Hospital Road, Fort Gordon, GA 30905-5670 | 2019-06-07 |
| 1366009805 | Briana Francina Krieger | Student in an Organized Health Care Education/Training Program | 300 East Hospical Road, Fort Gordon, GA 30905-5650 | 2019-05-21 |
| 1639735822 | Jon Thomas Heald | Student in an Organized Health Care Education/Training Program | Internal Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2019-05-14 |
| 1487218269 | David Keith Mecham | Student in an Organized Health Care Education/Training Program | Internal Medicine, Dwight David Eisenhower Army Medical, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2019-04-26 |
| 1740765544 | Jesse Goldblatt | Student in an Organized Health Care Education/Training Program | Clinical Psychology Internship Program, Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2018-09-27 |
| 1902390065 | Rafael Jacob Kaplan | Student in an Organized Health Care Education/Training Program | Ty, Dwight David Eisenhower Army Medical Center, 300 East Hospital Rd, Fort Gordon, GA 30905-5650 | 2018-06-21 |
| Find all providers in FORT GORDON | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.