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DMMD CONCIERGE LLC
NPI 1114562014
Family Medicine in Louisville, KY

Active since November 14, 2019CLIA 18D2175042 · Waiver
947 EASTERN PKWY, LOUISVILLE, KY 40217(502) 361-8801(502) 361-8821 Get Directions Write a Review

NPPES record last updated: January 30, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 30, 2020, Jan 7, 2020, Nov 14, 2019 (3 updates tracked since 2019).

About Dmmd Concierge Llc NPPES

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

DMMD CONCIERGE LLC (NPI 1114562014) is a healthcare organization registered as a family medicine in Louisville, Kentucky and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through November 13, 2027 and lists Doug Mattingly, Owner, as its authorized official.

NPPES Registry Identity

NPI1114562014
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDMMD CONCIERGE LLC
Location Address947 EASTERN PKWYLouisville, KY 40217-1573
Mailing Address3202 Thousand Oaks DrLouisville, KY 40205-2703
Phone(502) 361-8801
Fax(502) 361-8821
Organization SubpartNo
Authorized OfficialDoug MattinglyOwner · (502) 361-8801
Enumeration DateNovember 14, 2019
Last NPPES UpdateJanuary 30, 20203 updates tracked since enumeration
✔ NPI 1114562014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
947 EASTERN PKWY, Louisville, KY 40217
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Other Identifiers 1

Medicaid7100646490KY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dmmd Concierge Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Dmmd Concierge LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Douglas Mattingly, M.D.
Family Practice
NPI 1801851886
947 EASTERN PKWY
Louisville, KY 40217
(502) 361-8801
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2175042

Dmmd Concierge, LLC · Louisville, KY
Active · expires Nov 13, 2027
CLIA Number18D2175042
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorDr. Doug E. Mattingly
Laboratory Phone(502) 361-8801
Laboratory LocationDmmd Concierge, LLC947 Eastern Parkway, Louisville, KY 40217
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Dmmd Concierge LLC's NPI number?

The NPI number for Dmmd Concierge LLC is 1114562014. It was assigned to this organization in the NPPES registry on November 14, 2019.

Where is Dmmd Concierge LLC located?

Dmmd Concierge LLC is located at 947 Eastern Pkwy, Louisville, KY 40217. The listed phone number is (502) 361-8801.

What is Dmmd Concierge LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Dmmd Concierge LLC enrolled in Medicare?

Yes. Dmmd Concierge LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dmmd Concierge LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Dmmd Concierge LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dmmd Concierge LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2175042) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dmmd Concierge LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Dmmd Concierge LLC 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 Dmmd Concierge LLC was last updated on January 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.