GWYNETH MATTINGLY (NPI# 1982054672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982054672 |
| Entity Type | Individual |
| Full Name | GWYNETH MATTINGLY |
| Practice Address |
242 Brunswick St Old Town ME 04468-1613 |
| Mailing Address |
Po Box 1599 Bangor ME 04402-1599 |
| Practice Telephone | 2078276128 |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN47451 | ME | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP161067 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
242 BRUNSWICK ST |
| City | OLD TOWN |
| State | ME |
| Zip Code | 04468-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841283959 | Kay M Nash | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2005-08-24 |
| 1578194585 | Kara Middleton | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2020-01-29 |
| 1497317457 | Olivia Jasmin Greer | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2019-06-30 |
| 1215595749 | Justin J Cloukey | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2019-05-30 |
| 1144791849 | Destiny R Reynolds | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2018-12-07 |
| 1174020432 | Rachel Laura Kinney | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2018-04-12 |
| 1992219455 | Jeffrey Walton | Physical Therapist | 242 Brunswick St, Old Town, ME 04468-1613 | 2017-11-20 |
| 1518497395 | Collin Francis Zelinsky | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2017-06-14 |
| 1407307101 | James Cash Sr. | Chiropractor | 242 Brunswick St, Old Town, ME 04468-1613 | 2016-10-18 |
| 1760932552 | Amanda Langworthy | Registered Nurse | 242 Brunswick St, Old Town, ME 04468-1613 | 2016-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770730012 | Karen Laflamme Davis | Speech-Language Pathologist | 270-a Main St, Old Town, ME 04468 | 2008-08-19 |
| 1104028281 | Susan C Hoovler | Licensed Practical Nurse | 242 Brunswick St., Penobscot Community Health Center, Old Town, ME 04468 | 2007-06-01 |
| 1326251000 | City of Old Town | Local Education Agency (LEA) | 156 Oak St., Old Town, ME 04468 | 2007-05-08 |
| 1891832382 | Nancy J. Mitchell Home Trust | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Sandy Beach Lane, Indian Island, ME 04468 | 2007-01-31 |
| 1639274913 | Dianne E Kallen | Family Medicine | 252 Brunswick St, Old Town, ME 04468 | 2006-09-13 |
| 1023510898 | Riversedge Chiropractic Wellness Center LLC | Clinic/Center | 227 Main St, Old Town, ME 04468 | 2018-03-07 |
| 1134350077 | Kaliope C. Parousis | Pediatrics | 242 Brunswick Street, Old Town, ME 04468 | 2009-07-27 |
| 1568673267 | Merla Roy | Technician, Pathology | 23 Wabanaki Way, Indian Island, ME 04468 | 2007-05-24 |
| 1154440113 | Mckay Shared Living Services | Custodial Care Facility | 240 Main Street, Old Town, ME 04468 | 2007-03-28 |
| 1225153851 | Margo Downing | Registered Nurse | 23 Wabanaki Way, Indian Island, ME 04468 | 2007-03-20 |
| Find all providers in zip 04468 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023667516 | Kristi M Lord | Nurse Practitioner | 970 Ne 558th St, Old Town, FL 32680-9872 | 2019-09-06 |
| 1962772103 | Dawn Marie Aycock | Nurse Practitioner | 520 Ne 542nd St, Old Town, FL 32680-3818 | 2012-01-05 |
| 1215595749 | Justin J Cloukey | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2019-05-30 |
| 1861819377 | Kelly Ann Turner | Nurse Practitioner | 242 Brunswick St, Penobscot Community Health Center, Old Town, ME 04468-1613 | 2014-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730788852 | Kimberly Harvell | Nurse Practitioner | 37 Palmer Ln, Ste 3, Calais, ME 04619-1341 | 2020-10-20 |
| 1013515790 | Jana H Christman | Nurse Practitioner | 81 Medical Center Dr Ste 2150, Brunswick, ME 04011-2764 | 2020-10-14 |
| 1114539400 | Granite Hill Family Medicine LLC | Nurse Practitioner | 89 Water St, Hallowell, ME 04347-1477 | 2020-08-19 |
| 1073139465 | Jaclyn Kimberly Foraker | Nurse Practitioner | 885 Union St Ste 215, Bangor, ME 04401-3092 | 2020-06-22 |
| 1962023630 | Amy E Rousseau | Nurse Practitioner | 96 Campus Ave Ste 214, Lewiston Me, ME 04240-6019 | 2020-05-04 |
| 1952921488 | Amanda Rose Robbio | Nurse Practitioner | 244 Lakewood Rd, Skowhegan, ME 04950 | 2020-04-24 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1710529680 | Natasha Lynn Williamson | Nurse Practitioner | 63 Hurricane Rd, Gorham, ME 04038-2414 | 2019-10-11 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 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.