KELLY A. MATTHEWS LPN
NPI 1578857892
Licensed Practical Nurse in Port Jefferson Station, NY

Q: What is Kelly Matthews's NPI number?

The NPI number for Kelly Matthews is 1578857892. It was assigned to this individual provider in the NPPES registry on June 3, 2011. The provider is also known as Kelly A. Moon.

Q: What is Kelly Matthews's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Matthews was last updated on January 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 03, 2011

200 STERLING ST, PORT JEFFERSON STATION, NY 11776(631) 946-3167 Get Directions Write a Review

NPPES record last updated: January 25, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kelly A. Matthews Lpn NPPES

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

KELLY A. MATTHEWS LPN (NPI 1578857892) is an individual licensed practical nurse in Port Jefferson Station, New York, licensed in New York (3056061) and active in the NPI registry since June 2011.

NPPES Registry Identity

NPI1578857892

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameKELLY A. MATTHEWSCredential: LPN

Location Address200 STERLING STPort Jefferson Station, NY 11776-2530

Mailing Address200 Sterling StPort Jefferson Station, NY 11776-2530 · (631) 946-3167

Phone(631) 946-3167

Sole ProprietorYes

Enumeration DateJune 3, 2011

Last NPPES UpdateJanuary 25, 2013

✔ NPI 1578857892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in NY · 3056061

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

200 STERLING ST, Port Jefferson Station, NY 11776

Open in Google Maps ↗

Other Names 1

Former Name (1)Kelly A. Moon

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 Kelly Matthews's NPI number?

The NPI number for Kelly Matthews is 1578857892. It was assigned to this individual provider in the NPPES registry on June 3, 2011. The provider is also known as Kelly A. Moon.

Where is Kelly Matthews located?

Kelly Matthews practices at 200 Sterling St, Port Jefferson Station, NY 11776. The listed phone number is (631) 946-3167.

What is Kelly Matthews's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kelly Matthews was last updated on January 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.