MS. JESSICA LYNN MATIS DNP, APRN, ACNP-AG
NPI 1093164402
Nurse Practitioner - Acute Care in Baileys Crossroads, VA

Q: What is Jessica Matis's NPI number?

The NPI number for Jessica Matis is 1093164402. It was assigned to this individual provider in the NPPES registry on June 7, 2016.

Q: What is Jessica Matis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Matis was last updated on August 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 07, 2016

GOODWIN HOUSE, 3440 S. JEFFERSON STREET, BAILEYS CROSSROADS, VA 22041(703) 820-1488 Get Directions Write a Review

NPPES record last updated: August 15, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 15, 2019, Dec 27, 2016, Jun 13, 2016 (3 updates tracked since 2016).

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About Ms. Jessica Lynn Matis Dnp, Aprn, Acnp-ag NPPES

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

MS. JESSICA LYNN MATIS DNP, APRN, ACNP-AG (NPI 1093164402) is an individual acute care provider in Baileys Crossroads, Virginia, licensed in Kentucky (3010039) and active in the NPI registry since June 2016. She maintains a secondary practice location in Louisville.

NPPES Registry Identity

NPI1093164402

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameMS. JESSICA LYNN MATISCredential: DNP, APRN, ACNP-AG

Location AddressGOODWIN HOUSE, 3440 S. JEFFERSON STREETBaileys Crossroads, VA 22041-2204

Mailing Address2101 Mill Rd Apt 113Alexandria, VA 22314-5318 · (573) 450-1334

Phone(703) 820-1488

Sole ProprietorNo

Enumeration DateJune 7, 2016

Last NPPES UpdateAugust 15, 20193 updates tracked since enumeration

✔ NPI 1093164402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in KY · 3010039

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 3010039 (KY)

GOODWIN HOUSE, Baileys Crossroads, VA 22041

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Secondary Practice Location 1

Location 1210 E Gray St, Suite 1105Louisville, KY 40202-3900 · Phone (502) 583-1697 · Fax (502) 583-2120

Other Identifiers 5

Medicaid7100415610KY

Other0000001021475KY · Anthem - Nniky

Other215034LA · Siho - Nniky

Medicaid201391850IN

Other50112260KY · Passport - Nniky

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 Jessica Matis's NPI number?

The NPI number for Jessica Matis is 1093164402. It was assigned to this individual provider in the NPPES registry on June 7, 2016.

Where is Jessica Matis located?

Jessica Matis practices at Goodwin House 3440 S. Jefferson Street, Baileys Crossroads, VA 22041. The listed phone number is (703) 820-1488.

What is Jessica Matis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

When was this NPI record last updated?

The NPPES record for Jessica Matis was last updated on August 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.