LAURA P MATTINGLY (NPI# 1972692697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972692697 |
| Entity Type | Individual |
| Full Name | LAURA P MATTINGLY |
| Credential | PA |
| Practice Address |
855 Montgomery St Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8177352363 |
| Practice Fax Number | 8177352653 |
| Mailing Telephone | 8177352363 |
| Mailing Fax Number | 8177352653 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2015-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA03908 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 385175YS0Q | 05 | |
| TX | P01447517 | RAILROAD MEDICARE | 01 |
| TX | 183901101 | 05 | |
| TX | 183901102 | 05 | |
| TX | BCBS | 8245NN | 01 |
| TX | 183901104 | 05 | |
| TX | BCBS | 8Y9490 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316391782 | Laura Mattingly | Speech-Language Pathologist | 1115 Tamarack Rd, Suite 400, Owensboro, KY 42301-6984 | 2016-04-21 |
| Street Address |
855 MONTGOMERY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| 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 |
|---|---|---|---|---|
| 1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
| 1629681952 | Anum Bashwani | Physician Assistant | 5601 Bridge St Ste 450, Fort Worth, TX 76112-2305 | 2020-08-26 |
| 1780200881 | Emily Brown Holloway | Physician Assistant | 1904 Turner Ridge Dr Apt 5202, Fort Worth, TX 76110-2499 | 2020-06-24 |
| 1679196570 | Maria Cristela Mosso | Physician Assistant | 4521 S Hulen St Ste 118, Fort Worth, TX 76109-4954 | 2020-05-26 |
| 1679195978 | Jacob Torre | Physician Assistant | 1701 River Run Ste 1118, Fort Worth, TX 76107-6557 | 2020-05-11 |
| 1871122382 | Kenaud Jeune | Physician Assistant | 5817 Fairglen Ave Apt 312, Fort Worth, TX 76137-6810 | 2020-04-06 |
| 1922635648 | Lauren Elizabeth Studey | Physician Assistant | 3470 Sagecrest Ter, Fort Worth, TX 76109-2555 | 2020-03-24 |
| 1033743612 | James Bregg Reedy | Physician Assistant | 200 W Magnolia Ave Ste 201, Fort Worth, TX 76104-7657 | 2020-02-24 |
| 1992335194 | Alexandria Christine Rios | Physician Assistant | 5904 Rockhill Rd, Fort Worth, TX 76112-3047 | 2020-01-16 |
| 1982253605 | Kelly Ann Klein | Physician Assistant | 6708 River Bend Rd, Fort Worth, TX 76132-1108 | 2019-09-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on LAURA P MATTINGLY.
| 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.