KIMBERLY DEMATTIE APRN-CNP LSW NPI 1154834539

NPI Information

  • NPI: 1154834539
  • Provider Name: KIMBERLY DEMATTIE, APRN-CNP, LSW
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 205 MARION PIKE
    COAL GROVE, OH
    ZIP 45638
  • Phone: (740) 532-1188

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NPI Details

Kimberly Demattie, APRN-CNP, LSW is a psychiatric/mental health nurse practitioner in Coal Grove, OH. 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:

205 MARION PIKE
COAL GROVE, OH
ZIP 45638-165
Phone: (740) 532-1188

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 8/29/2024.

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
1104100000XSocial WorkerS.0028154OHIONo
2163W00000XRegistered NurseRN.444863OHIONo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN.CNP.0026784OHIOYes

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
10405888MEDICAIDOHIO
27100763640MEDICAIDKENTUCKY

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: 3/30/2025

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