Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Rene Mattimoe, FNP

Individual provider Family Nurse Practitioner · NPI 1235867623

Kelly Rene Mattimoe, FNP is a Nurse Practitioner in Odessa, Texas. Qualified in 2022, 4 years ago. Practices with James Y Li Mdpa, a 3-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2022
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

612 N Washington Ave Ste 200
Odessa, TX 79761-4436
Phone: (432) 332-9263
Fax: (432) 332-9264
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1085712 (TX)

Record details

NPI number1235867623
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 12, 2022
Last updated in NPPESAugust 12, 2022
Certification dateAugust 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice James Y Li Mdpa — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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