KILEY KRISTINE MATTOX (NPI# 1841775277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841775277 |
| Entity Type | Individual |
| Full Name | KILEY KRISTINE MATTOX |
| Credential | NP |
| Practice Address |
205 N Tillotson Ave Muncie IN 47304-3900 |
| Mailing Address |
240 N Tillotson Ave Muncie IN 47304-3988 |
| Practice Telephone | 7652881995 |
| Mailing Telephone | 7652881928 |
| Mailing Fax Number | 7657410335 |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71008663A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
71008663A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
205 N TILLOTSON AVE |
| City | MUNCIE |
| State | IN |
| Zip Code | 47304-3900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235110503 | James R Byrn | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2005-11-14 |
| 1154842813 | Fnu Sandhia | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2017-07-03 |
| 1700331725 | Makenzie Lindauer | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2016-08-19 |
| 1457718975 | Kelly White | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2016-01-28 |
| 1780056481 | Kimberly Robinson | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2015-10-21 |
| 1053707075 | Stephanie Stewart | Social Worker | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2015-04-07 |
| 1629473053 | Meridian Health Services Corp | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2014-10-28 |
| 1588063846 | Emily Voerman | Physical Therapist | 205 N Tillotson Ave, Room Rehab, Muncie, IN 47304-3900 | 2014-08-21 |
| 1952714164 | Molly A Jones | Speech-Language Pathologist | 205 N Tillotson Ave, Room Rehab, Muncie, IN 47304-3900 | 2014-06-05 |
| 1225457450 | Meridian Health Services Corp | Speech-Language Pathologist | 205 N Tillotson Ave, Room Rehab, Muncie, IN 47304-3900 | 2014-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821627191 | Free To Flourish Counseling and Consulting | Marriage & Family Therapist | 4304 W Coyote Run Court, Muncie, IN 47304 | 2020-04-07 |
| 1205477957 | Muncie Treatment Center, LLC | Clinic/Center | 3640 Briarwood Lane, Muncie, IN 47304 | 2019-10-03 |
| 1508415225 | Susanna Florence Nalliah I | Pharmacist | Iu Health Ball Memorial Hospital Inpatient Pharmacy, 2401 W. University Ave, Muncie, IN 47304 | 2019-09-05 |
| 1235624289 | Kregg Koons O.d., Inc. | Optometrist | 3300 Purdue Ave., Muncie, IN 47304 | 2018-06-22 |
| 1013409242 | Julia Powers | Social Worker | 8425 W Ashford Ln, Muncie, IN 47304 | 2018-06-04 |
| 1851803456 | Dianna Marie Johnson | Nurse Practitioner | 3411 N Briarwood Ln, Muncie, IN 47304 | 2017-11-04 |
| 1780082917 | Quad Med LLC | Clinic/Center | 3800 West Kilgore Ave, Muncie, IN 47304 | 2014-12-22 |
| 1629418173 | Mark Allen Wise | Physical Therapist | 3607 N Everbrook Lane, Muncie, IN 47304 | 2013-06-28 |
| 1396094280 | Planned Parenthood of Indiana Muncie | Clinic/Center | 3550 W. Fox Ridge Lane, Muncie, IN 47304 | 2012-09-06 |
| 1043595655 | Olukayode Bamidele | Physical Therapist | 3601 W. Moore Road, Muncie, IN 47304 | 2011-10-14 |
| Find all providers in zip 47304 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700331725 | Makenzie Lindauer | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2016-08-19 |
| 1740639186 | Ashley Marisa Keim | Nurse Practitioner | 333 S Madison St, Muncie, IN 47305-2465 | 2016-06-07 |
| 1457718975 | Kelly White | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2016-01-28 |
| 1831561133 | Nicole Marie Rector | Nurse Practitioner | 2525 W University Ave, Suite 404, Muncie, IN 47303-3421 | 2015-10-26 |
| 1780056481 | Kimberly Robinson | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2015-10-21 |
| 1104188754 | Melinda Smith | Nurse Practitioner | 333 S Madison St, Muncie, IN 47305-2465 | 2012-06-11 |
| 1013286699 | Chasity R Evans | Nurse Practitioner | 2525 W University Ave, Suite 404, Muncie, IN 47303-3421 | 2011-12-28 |
| 1518272582 | Amy L Orr | Nurse Practitioner | 3807 S Madison St, Muncie, IN 47302-5758 | 2010-08-13 |
| 1225188667 | Kristin Lawson | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2007-01-10 |
| 1821167073 | Catherine Oplinger | Nurse Practitioner | 205 N Tillotson Ave, Muncie, IN 47304 | 2006-11-06 |
| Find all providers in MUNCIE | ||||
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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.