Matthew Campbell, LAT, ATC, ITAT, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36002135A Issued in IN

Practice address

7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Phone

(260) 458-3640

Fax

(260) 479-1819

NPI assigned

Jul 25, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: matthew.campbell@lutheranhealthnetwork.cernerdirect.com
• FHIR API: https://api.platform.athenahealth.com/1725/brand/1/csg/1/fhir/r4

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.

• Physical Medicine Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Fort Wayne, IN
  • NPI 1447314067
  NPD (past)

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1114369626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7956 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-273-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7956 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-458-3640",
            "fax_number": "260-479-1819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7201 Engle Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468042228",
            "country_code": "US",
            "telephone_number": "260-432-1800 x316",
            "fax_number": "260-432-1804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 University Ave",
            "address_purpose": "LOCATION",
            "city": "Angola",
            "state": "IN",
            "postal_code": "467031764",
            "country_code": "US",
            "telephone_number": "260-273-2281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Freeman St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468024713",
            "country_code": "US",
            "telephone_number": "260-479-3498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC, ITAT, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2024-04-01",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002135A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.campbell@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Message",
            "address_1": "7956 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David A Campbell, MD
• David Todd Campbell, LCSW
• Jenna Campbell
• Jennifer Campbell, PHARMD
• Karen M Campbell, LMHC
• Stacy Campbell, BSN, RN
• Vincent Gerard Campbell, OTR
• Samantha Michael Camperman, RBT
• Vincent Joseph Campiti, MD
• Cecilia Campos Goroztieta, RBT

• Athletic Trainer in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.