KIMBERLY DEMATTIE APRN-CNP LSW NPI 1154834539

NPI Information

NPI: 1154834539
Provider Name: KIMBERLY DEMATTIE, APRN-CNP, LSW
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
55 TOWNSHIP ROAD 508 E
SOUTH POINT, OH
ZIP 45680
Phone: (740) 377-2712
Get Directions

Kimberly Demattie, APRN-CNP, LSW is a psychiatric/mental health nurse practitioner in South Point, OH with 4 years of experience. Kimberly Demattie, APRN-CNP, LSW NPI is 1154834539. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

55 TOWNSHIP ROAD 508 E
SOUTH POINT, OH
ZIP 45680-276
Phone: (740) 377-2712
Fax: (740) 377-2588

The NPI 1154834539 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/8/2017 and was last updated on 9/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	104100000X	Social Worker		S.0028154	OHIO	No
2	163W00000X	Registered Nurse		RN.444863	OHIO	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN.CNP.0026784	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100763640	MEDICAID	KENTUCKY
2	0405888	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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