Active NPI
Matthew Johnson, LAT, ATC
- Athletic Trainer
- Austin, TX
National Provider Identifier
1073753992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT4305
- Practice address
- 5600 Sunshine Dr
Austin, TX 78756-1598 - Phone
- (512) 414-2519
- NPI assigned
- Mar 5, 2009
- 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 | AT4305 | TX | Primary |
Addresses
Primary practice location
5600 Sunshine Dr
Austin, TX 78756-1598
Mailing address
9415 McNeil Dr Apt 1134
Austin, TX 78750-8574
Phone (512) 202-6251
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT4305 | Other | TX | ADVISORY BOARD OF ATHLETIC TRAINERS |
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 |
|---|---|---|---|
| AT4305 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777248000000",
"number": "1073753992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9415 MCNEIL DR APT 1134",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787508574",
"telephone_number": "512-202-6251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 SUNSHINE DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787561598",
"telephone_number": "512-414-2519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MATTHEW",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-05",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT4305",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVISORY BOARD OF ATHLETIC TRAINERS",
"identifier": "AT4305",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.