Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. KELLY DAWN MATTIX MD
NPI 1063685956
Surgery - Pediatric Surgery in Springdale, AR

Q: What is Kelly Mattix's NPI number?

The NPI number for Kelly Mattix is 1063685956. It was assigned to this individual provider in the NPPES registry on April 11, 2008.

Q: What is Kelly Mattix's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Mattix was last updated on October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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.

Active since April 11, 2008PECOS Enrolled

2601 GENE GEORGE BLVD, SPRINGDALE, AR 72762(479) 725-6800(479) 725-6582 Get Directions Write a Review

NPPES record last updated: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Oct 2, 2026, Oct 3, 2023, Apr 27, 2021 and 1 more (4 updates tracked since 2019).

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About Dr. Kelly Dawn Mattix Md NPPES

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

DR. KELLY DAWN MATTIX MD (NPI 1063685956) is an individual pediatric surgery provider in Springdale, Arkansas, licensed in Arkansas (E-17038) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS and maintains a secondary practice location in Temple.

NPPES Registry Identity

NPI1063685956

Entity TypeIndividualFemale

Primary Taxonomy2086S0120X

Provider Legal NameDR. KELLY DAWN MATTIXCredential: MD

Location Address2601 GENE GEORGE BLVDSpringdale, AR 72762-0845

Mailing AddressPo Box 959794Saint Louis, MO 63195-9794 · (501) 364-1100 · Fax (501) 978-6436

Phone(479) 725-6800

Fax(479) 725-6582

Sole ProprietorYes

Enumeration DateApril 11, 2008

Last NPPES UpdateOctober 2, 20264 updates tracked since enumeration

NPPES CertifiedOctober 2, 2026

✔ NPI 1063685956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0120X

Licenses✔ Licensed in AR · E-17038✔ Licensed in TX · N7560

Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

Also ListedSurgeryTaxonomy 208600000X · License E-17038 (AR)

2601 GENE GEORGE BLVD, Springdale, AR 72762

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Secondary Practice Location 1

Location 11901 SW H K Dodgen LoopTemple, TX 76502-1814 · Phone (254) 724-5437

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Dawn Mattix Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT CATON BAKER MD

Anesthesiology (Pediatric Anesthesiology)