DR. CARL G MATTACOLA (NPI# 1225000706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225000706 |
| Entity Type | Individual |
| Full Name | DR. CARL G MATTACOLA |
| Credential | PHD |
| Practice Address |
900 South Limestone Lexington KY 40536-0001 |
| Mailing Address |
Indigo Farm 2282 Danville Road Harrodsburg KY 40330 |
| Practice Telephone | 8593231100 |
| Practice Fax Number | 8593236003 |
| Mailing Telephone | 8593231100 |
| Mailing Fax Number | 8593236003 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246Z00000X | Specialist/Technologist, Other | AT 400 | KY | Technologists, Technicians & Other Technical Service Providers |
| Y | 246Z00000X | Specialist/Technologist, Other | AT400 | KY | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
900 SOUTH LIMESTONE |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40536-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326581612 | Carrie Baker | Specialist/Technologist | 900 South Limestone, 210b, Lexington, KY 40509 | 2016-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790394583 | Mary Luz Calderon | Physician Assistant | Uk Pediatric Neonatology, 800 Rose St 4th Fl, Lexington, KY 40536 | 2020-07-28 |
| 1598389421 | Storm Bryant Dutton | Physician Assistant | Uk Emergency Department - Chandler, 1000 S Limestone, Lexington, KY 40536 | 2020-06-06 |
| 1720601545 | Tyler Allen Pape | Physician Assistant | Uk Surgery Clinic - General, 740 S Limestone Ste L104, Lexington, KY 40536 | 2020-05-27 |
| 1417579269 | Kacy Clinkenbeard | Physician Assistant | Uk Healthcare-icu, 800 Rose St, Lexington, KY 40536 | 2020-05-15 |
| 1023578804 | William Chalmers Ruffin | Student in an Organized Health Care Education/Training Program | 740 South Limestone St. E300e, Lexington, KY 40536 | 2019-03-20 |
| 1942705728 | Karah Lee Ellen Brown | Dentist | 800 Rose Street, Room D-508, Lexington, KY 40536 | 2018-03-26 |
| 1982109708 | Khader Samir Habash | Dentist | 740 S Limestone Room A262, Lexington, KY 40536 | 2018-03-25 |
| 1609370683 | Casey Michael Fitzgerald | Otolaryngology | 740 South Limestone Ears Nose and Throat Clinic, Lexington, KY 40536 | 2018-03-22 |
| 1538663992 | Heather Oaks | Nurse Practitioner | Uk Gill Heart Institute 800 Rose St, Lexington, KY 40536 | 2018-03-21 |
| 1396268223 | Prasanna Kumar Gangishetti | Pediatrics | 800 Rose St Rm No Mn-118, Lexington, KY 40536 | 2017-07-23 |
| Find all providers in zip 40536 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780854513 | Linda J Gassaway | Specialist/Technologist, Other | 961 Beasley St, Ste. 140, Lexington, KY 40509-4131 | 2008-03-07 |
| 1356792725 | Kate Jochimsen | Specialist/Technologist, Other | University of Kentucky, 900 South Limestone, Lexington, KY 40536-0001 | 2016-06-28 |
| 1760727275 | Jonathan Beck | Specialist/Technologist, Other | 771 Corporate Dr, Suite 610, Lexington, KY 40503-5405 | 2012-12-10 |
| 1053656728 | Rachel Vanlaningham | Specialist/Technologist, Other | 771 Corporate Dr, Suite 610, Lexington, KY 40503-5405 | 2012-12-06 |
| 1427304096 | Nicole Lafountain | Specialist/Technologist, Other | 771 Corporate Dr, Suite 610, Lexington, KY 40503-5405 | 2012-08-01 |
| 1922354570 | Brittany Douglas | Specialist/Technologist, Other | 771 Corporate Dr, Suite 610, Lexington, KY 40503-5405 | 2012-08-01 |
| 1619234325 | Kayla M Downing | Specialist/Technologist, Other | 771 Corporate Dr, Suite 610, Lexington, KY 40503-5405 | 2012-04-19 |
| 1386857407 | University of Kentucky Medical Center | Specialist/Technologist, Other | 800 Rose St, 306 Combs Building, Lexington, KY 40536-0001 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1871151407 | Andrea Wiggins Clark | Specialist/Technologist, Other | 9482 Brownsboro Rd, Louisville, KY 40241-1118 | 2019-05-29 |
| 1558602110 | Kentucky Diagnostics | Specialist/Technologist, Other | 7321 New L Agrange Road, Suite 207, Louisville, KY 40222 | 2013-03-07 |
| 1447562632 | Kara Elizabeth Smith | Specialist/Technologist, Other | 1300 Academy Dr, Hopkinsville, KY 42240-2654 | 2010-07-05 |
| 1053643346 | Aida Sehic | Specialist/Technologist, Other | 3005 Springcrest Dr, Louisville, KY 40241-2755 | 2010-02-11 |
| 1093948622 | Kelly Ford | Specialist/Technologist, Other | 2200 E Parrish Ave., Bldg B, Ste 203, Owensboro, KY 42303 | 2009-08-31 |
| 1831348069 | Elmer M Tribble | Specialist/Technologist, Other | 9205 Rainbow Springs Ct, Apt. 5, Louisville, KY 40241-2243 | 2008-09-11 |
| 1306094024 | Daniel Edward Crowley | Specialist/Technologist, Other | 149 Raleigh Dr, Apt. 1e, Elizabethtown, KY 42701-4135 | 2008-09-06 |
| 1780870378 | Vivid Diagnostic | Specialist/Technologist, Other | 132 Grand Vue Plz, Unit 6, Hazard, KY 41701-6842 | 2007-09-18 |
| 1134329469 | Monica Moss Shelton | Specialist/Technologist, Other | 382 Irish Cir, Hopkinsville, KY 42240-1779 | 2007-07-24 |
| Find all providers with the same taxonomy | ||||
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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.