KATHERINE ANN MATTINGLY (NPI# 1699774174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699774174 |
| Entity Type | Individual |
| Full Name | KATHERINE ANN MATTINGLY |
| Credential | PA-C |
| Practice Address |
122 Wyoming St Dayton OH 45409-2731 |
| Practice Telephone | 9372234461 |
| Practice Fax Number | 9372241945 |
| Mailing Telephone | 9372234461 |
| Mailing Fax Number | 9372241945 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2014-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50002181 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0067797 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972167633 | Katherine Rose Mattingly | Behavior Technician | 7264 Columbia Rd Ste 1000, Mason, OH 45039-8086 | 2019-04-29 |
| 1003372079 | Katherine Mattingly | Physician Assistant | 201 E Grover St, Shelby, NC 28150-3917 | 2019-02-14 |
| Street Address |
122 WYOMING ST |
| City | DAYTON |
| State | OH |
| Zip Code | 45409-2731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760484943 | Hema Pandrangi | Internal Medicine | 122 Wyoming St, Dayton, OH 45409-2731 | 2005-06-01 |
| 1790338523 | Timothy Brophy | Nurse Practitioner | 122 Wyoming St, Dayton, OH 45409 | 2019-07-21 |
| 1023660388 | Cody Thomas Ash | Nurse Practitioner | 122 Wyoming St, Dayton, OH 45409 | 2019-07-16 |
| 1548825383 | Rebekah Thurston | Registered Nurse | 122 Wyoming St, Dayton, OH 45409-2731 | 2019-05-07 |
| 1164997979 | Raymond Joseph Simpson | Registered Nurse | 122 Wyoming St, Dayton, OH 45409-2731 | 2018-10-08 |
| 1750877171 | Erin Peden | Nurse Practitioner | 122 Wyoming St, Dayton, OH 45409 | 2018-07-09 |
| 1306360904 | Tiffany Staples | Registered Nurse | 122 Wyoming St, Dayton, OH 45409-2731 | 2017-07-26 |
| 1013460641 | Jamie Seiley | Registered Nurse | 122 Wyoming St, Dayton, OH 45409-2731 | 2016-08-01 |
| 1093162703 | Melissa G Cotter | Registered Nurse | 122 Wyoming St, Dayton, OH 45409-2731 | 2016-05-23 |
| 1760844609 | Vanessa Holley | Nurse Practitioner | 122 Wyoming St, Dayton, OH 45409-2731 | 2016-03-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487276457 | Matthew R Schaeffer | Surgery | 128 E Apple St., Wche 7th Floor, Dayton, OH 45409 | 2020-05-13 |
| 1699237545 | Elizabeth Joan Hudson | Student in an Organized Health Care Education/Training Program | 1 Wyoming Street Miami Valley Hospital Medical Educatio, Dayton, OH 45409 | 2019-04-01 |
| 1760941066 | Courtney Lyn Johnson | Surgery | 128 East Apple Street, Wche 7th Floor, Dayton, OH 45409 | 2019-03-16 |
| 1477057529 | Adam Joseph Langer | Student in an Organized Health Care Education/Training Program | 128 E. Apple St Suite 3800, Wright State University Dept of Ob/gyn, Dayton, OH 45409 | 2018-03-22 |
| 1659870939 | Timothy Wall | Student in an Organized Health Care Education/Training Program | 128 East Apple St., 2nd Floor, Dayton, OH 45409 | 2018-02-01 |
| 1124551411 | Adam Schmerge Deardorff | Student in an Organized Health Care Education/Training Program | 30 E Apple St Ste 6257, Dayton, OH 45409 | 2017-04-04 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1689054223 | Jessica Ezinne Ugwu | Family Medicine | 30 E Apple St., Suite Nw 3300, Dayton, OH 45409 | 2015-06-08 |
| 1679983084 | Jude Anneryan Cohen | Registered Nurse | 1200 W. Dorothy Lane, Southdale Elementary School, Kettering, OH 45409 | 2014-05-07 |
| 1730517087 | Jesse Wayne Clark | Counselor | 65 Grady Ct, Dayton, OH 45409 | 2013-10-24 |
| Find all providers in zip 45409 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091241 | Beau Webb | Physician Assistant | 6017 Cruxten Dr, Dayton, OH 45424-3702 | 2020-10-18 |
| 1043838782 | Marie Therese Mualla Oram | Physician Assistant | 204 Sears St Apt 518, Dayton, OH 45402-1573 | 2020-07-09 |
| 1720542509 | Herodina Ibanez Lu | Physician Assistant | 1 Elizabeth Pl Nwb Ste 15, Dayton, OH 45417-3445 | 2019-01-25 |
| 1427585819 | Mita Morar | Physician Assistant | 938 Olde Sterling Way, Dayton, OH 45459-3100 | 2017-05-16 |
| 1306394275 | Danielle Elizabeth Tirjer Cleary | Physician Assistant | 320 Judith Dr, Dayton, OH 45429-5306 | 2016-09-20 |
| 1831555234 | Lisa Byers | Physician Assistant | 7980 N Main St, Dayton, OH 45415-2328 | 2016-01-14 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1104201730 | Dominique Hunt | Physician Assistant | 5300 Far Hills Ave Ste 300, Dayton, OH 45429-2381 | 2015-07-24 |
| 1285025957 | Holly Griffin | Physician Assistant | 4340 Clyo Rd, Dayton, OH 45459-7000 | 2015-02-16 |
| 1073885216 | Shawn Breeding | Physician Assistant | 627 Edwin C. Moses Blvd, Suite K, Dayton, OH 45417-3474 | 2012-02-03 |
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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.