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JONATHAN ROBERT MATTINGLY
NPI 1962105833
General Practice in Louisville, KY

Active since March 22, 2023PECOS Enrolled
500 S PRESTON ST, LOUISVILLE, KY 40202(502) 852-5193 Get Directions Write a Review

NPPES record last updated: September 9, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 9, 2026, Mar 22, 2023 (2 updates tracked since 2023).

About Jonathan Robert Mattingly NPPES

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

JONATHAN ROBERT MATTINGLY (NPI 1962105833) is an individual general practice provider in Louisville, Kentucky, licensed in Kentucky (R7408) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962105833
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameJONATHAN ROBERT MATTINGLY
Location Address500 S PRESTON STLouisville, KY 40202-1702
Mailing Address7805 Binford WayLouisville, KY 40291-5279 · (502) 489-4641
Phone(502) 852-5193
Sole ProprietorYes
Enumeration DateMarch 22, 2023
Last NPPES UpdateSeptember 9, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2026
✔ NPI 1962105833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in KY · R7408
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
500 S PRESTON ST, Louisville, KY 40202
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Robert Mattingly 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.

DIVIJA SHARMA
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193
CAITLIN RAE WESSEL
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193
ASHLEY-SHAE BENTON
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193
CHRISTOPHER CRAFTON
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193
MEGAN LYNN LIBKE
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-1499
NICHOLAS JAMES YEAGER MD
Anesthesiology
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193
MR. SHANE MATTHEW HAYDON
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 554-3523
EMMA ELIZABETH FEARON
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193

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 Jonathan Mattingly's NPI number?

The NPI number for Jonathan Mattingly is 1962105833. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Jonathan Mattingly located?

Jonathan Mattingly practices at 500 S Preston St, Louisville, KY 40202. The listed phone number is (502) 852-5193.

What is Jonathan Mattingly's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jonathan Mattingly enrolled in Medicare?

Yes. Jonathan Mattingly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jonathan Mattingly was last updated on September 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.