Gobel E Mattingly, MS, PTA, ATC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 001823 Issued in WV

Practice address

943 Maple Dr
Morgantown, WV 26505-2812

Phone

(304) 599-2515

NPI assigned

May 7, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1013235548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 MAPLE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052812",
            "telephone_number": "304-599-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 MAPLE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052812",
            "telephone_number": "304-599-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "GOBEL",
        "middle_name": "E",
        "credential": "MS, PTA, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "PTA 001823",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSISTANT",
            "identifier": "PTA 001823",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC CERTIFICATION",
            "identifier": "070702738",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittney Matlick, MS, LPC, LMFT
• Malcolm D Mattes, M.D.
• Matthew Miller DDS PLLC
• Kimberly Diane Matthews Christopher, CRNA
• Bayley Elizabeth Matthey
• Kimberly A Matuga
• Rebekah Suzanne Matuga, PHARMD
• Rita L Matulavich, CRNA
• Lauren Elizabeth Matusky
• Valerie L Matyus, APN

• Physical Therapy Assistant in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.