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MRS. KIMBERLY RUTH MATTINGLY-CLOER
NPI 1053040048
Counselor in Statesville, NC

Active since June 07, 2022PECOS Enrolled
1812 DAVIE AVE, STATESVILLE, NC 28677(704) 450-8277 Get Directions Write a Review

NPPES record last updated: June 7, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mrs. Kimberly Ruth Mattingly-cloer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KIMBERLY RUTH MATTINGLY-CLOER (NPI 1053040048) is an individual counselor in Statesville, North Carolina, licensed in North Carolina (C014138) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1053040048
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMRS. KIMBERLY RUTH MATTINGLY-CLOER
Location Address1812 DAVIE AVEStatesville, NC 28677-3524
Mailing Address456 Seven Springs LoopStatesville, NC 28625-9137 · (704) 929-6117
Phone(704) 450-8277
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateJune 7, 2022
NPPES CertifiedJune 7, 2022
✔ NPI 1053040048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in NC · C014138
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
1812 DAVIE AVE, Statesville, NC 28677
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Other Identifiers 1

Other01Private Pay

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kimberly Ruth Mattingly-cloer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779009204
PECOS Enrollment IDI20250428004219
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Mattingly-cloer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Eventus Wholehealth, PLLC
31 mi
Family Medicine
101 CABARRUS AVE E STE 200
Concord, NC 28025
  • Reassigned Medicare billing, North Carolina enrollment
  • 312 clinicians in this Medicare group
NPI 1548759392 (855) 743-2247

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Mattingly-cloer's NPI number?

The NPI number for Kimberly Mattingly-cloer is 1053040048. It was assigned to this individual provider in the NPPES registry on June 7, 2022.

Where is Kimberly Mattingly-cloer located?

Kimberly Mattingly-cloer practices at 1812 Davie Ave, Statesville, NC 28677. The listed phone number is (704) 450-8277.

What is Kimberly Mattingly-cloer's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Kimberly Mattingly-cloer enrolled in Medicare?

Yes. Kimberly Mattingly-cloer is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Mattingly-cloer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Mattingly-cloer reassigns Medicare benefits to Eventus Wholehealth, PLLC (Concord, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Mattingly-cloer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Mattingly-cloer accept?

Health plans from Blue Cross and Blue Shield of NC list Kimberly Mattingly-cloer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Mattingly-cloer was last updated on June 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.