Active NPI
Matthew Dean Loyd
- Athletic Trainer
- Bolivar, MO
National Provider Identifier
1063872281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2015028942
- Practice address
- 1600 University Ave
Bolivar, MO 65613-2578 - Phone
- (417) 777-7763
- NPI assigned
- Mar 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2015028942 | MO | Primary |
Addresses
Primary practice location
1600 University Ave
Bolivar, MO 65613-2578
Mailing address
1600 University Ave
Bolivar, MO 65613-2578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015028942 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456790400000",
"number": "1063872281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 UNIVERSITY AVE",
"city": "BOLIVAR",
"state": "MO",
"postal_code": "656132578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 UNIVERSITY AVE",
"city": "BOLIVAR",
"state": "MO",
"postal_code": "656132578",
"telephone_number": "417-777-7763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOYD",
"first_name": "MATTHEW",
"middle_name": "DEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-01",
"last_updated": "2016-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2015028942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolivar, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.