Individual provider Active NPI

Matthew J Glogowski, ATC

  • Athletic Trainer
  • Orange Park, FL
National Provider Identifier
1104890409
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL652 Issued in FL
Practice address
920-1 Blanding Blvd
Orange Park, FL 32065
Phone
(904) 298-0882
Fax
(904) 298-0883
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL652 FL Primary

Addresses

Primary practice location

920-1 Blanding Blvd
Orange Park, FL 32065

Mailing address

2704 Ridge Haven St
Green Cove Springs, FL 32043-5275
Phone (904) 291-3417

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

LicenseStateTypeSpecialty
AL652FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Surgery Center LTD Current Accepting new patients
Atlanta Surgery Center, LTD Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104890409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 RIDGE HAVEN ST",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320435275",
            "telephone_number": "904-291-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920-1 BLANDING BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32065",
            "telephone_number": "904-298-0882",
            "fax_number": "904-298-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOGOWSKI",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.