Austin Matlock, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2011025934 Issued in MO

Practice address

820 Chestnut St
115 Jason Hall
Jefferson City, MO 65101-3537

Phone

(573) 681-5331

NPI assigned

Apr 23, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1003236506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609A SOUTHRIDGE DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 CHESTNUT ST",
            "address_2": "115 JASON HALL",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013537",
            "telephone_number": "573-681-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2011025934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David R. Marty, M.D.
• Lynn Marty, FNP
• Judy Kaye Massman, LPC, LCSW
• Tammy Massman, LCSW
• Hayley Christine Mathie, DDS
• Jack E Matteson, M.D.
• Allyson Nicole Matthesen, PA-C
• Matthew Gassen D.D.S., P.C.
• Andrew Wayne Mauck, LMSW
• Jennifer Maurer

• Athletic Trainer in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.