Active NPI
Matthew D Gerken, ATC
- Athletic Trainer
- Gorham, ME
National Provider Identifier
1073549523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT137
- Practice address
- 37 College Ave
Gorham, ME 04038-1032 - Phone
- (207) 780-5140
- Fax
- (207) 780-5354
- NPI assigned
- Jun 25, 2006
- Sex
- Male
- Sole proprietor
- No
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 | AT137 | ME | Primary |
Addresses
Primary practice location
37 College Ave
Gorham, ME 04038-1032
Mailing address
37 College Ave
Gorham, ME 04038-1032
Phone (207) 780-5140
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 |
|---|---|---|---|
| AT137 | ME | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Maine System | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba University of Southern Maine
- Student Health Clinic/Center
- Gorham, ME
- NPI 1780020941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368576000000",
"number": "1073549523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 COLLEGE AVE",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381032",
"telephone_number": "207-780-5140",
"fax_number": "207-780-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 COLLEGE AVE",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381032",
"telephone_number": "207-780-5140",
"fax_number": "207-780-5354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERKEN",
"first_name": "MATTHEW",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2013-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ME",
"license": "AT137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gorham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.