Matthew Kirkpatrick

Individual provider Active NPI Athletic Trainer · Foxborough, MA

NPI 1164186342 · NPPES record last updated Oct 25, 2021

Key facts

NPI
1164186342
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2990 (MA)
Practice address
1776 Revolution Way
Foxborough, MA 02035-1157
Phone
(508) 734-0794
NPI assigned
Oct 25, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
25MT00207500NJMDAthletic Trainer
RT005954PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT005954 PA
Athletic Trainer 2255A2300X 2990 MA Yes
Athletic Trainer 2255A2300X 25MT00207500 NJ

Addresses

Primary practice location

1776 Revolution Way
Foxborough, MA 02035-1157

Mailing address

230 Stonehaven Dr
Red Hill, PA 18076-1412

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Cerner

Other providers in Foxborough, MA

All providers in Foxborough, MA · Athletic Trainer in Massachusetts

Sources for this page

Verify at the official NPI Registry.