Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1174114086 Deactivated / Inactive NPI Male Practitioner

David Allen Mattingly , R PH

Pharmacist • Herrin, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, David Mattingly has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 02, 2021
NPI Deactivation Date November 27, 2025
Total Practice Duration ~4 Years of Practice (2021 – 2025)

Professional Overview & Biography Verified Profile Summary

David Mattingly, R PH was a registered Pharmacist practicing in Herrin, IL. Throughout an active medical career spanning 4 years, David Mattingly provided care at the practice location at 116 N PARK AVE until profile deactivation on 2025-11-27.

Practice Location & Contact Primary Location

Practice Address

116 N Park Ave

Herrin, IL 62948

Telephone 6189425315
Fax 6189424584
Associated Practice Facility / Clinic
🏢 Herrin Drug Inc Facility NPI 1417947870

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Herrin, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
21 Specialists

Practicing in Herrin, IL (9983 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License IL 051033298

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Scot Walker , PharmD

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI 1457202624

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 27, 2025

Record deactivated on November 27, 2025

NPI Profile Active February 02, 2021

NPI status registered as active in NPPES database

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Updated Practice Location February 02, 2021

Registered at 116 N PARK AVE, HERRIN, IL 62948 (Tel: 6189425315)

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Updated Business Mailing Address February 02, 2021

Registered at 116 N PARK AVE, HERRIN, IL 62948 (Tel: 6189425315)

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Provider Name / Credentials Updated February 02, 2021

Recorded as DAVID MATTINGLY, R. PH.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 02, 2021

Pharmacist (License #051033298 in IL)

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Initial NPI Registration & Enumeration February 02, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174114086
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 02, 2021
Last Update: February 02, 2021
Deactivation Date: November 27, 2025

Mailing Address

116 N Park Ave

Herrin, IL 62948

Phone: 6189425315

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.