Active NPI
Matthew Jerome Bussman, A.T.C.
- Athletic Trainer
- Seattle, WA
National Provider Identifier
1235376369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A1 60047682
- Practice address
- 901 12TH Ave
Athletics Building
Seattle, WA 98122-4411 - Phone
- (206) 296-5432
- Fax
- (206) 296-2154
- NPI assigned
- Jan 12, 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 | A1 60047682 | WA | Primary |
Addresses
Primary practice location
901 12TH Ave
Athletics Building
Seattle, WA 98122-4411
Mailing address
901 12TH Avenue
PO Box 222000
Seattle, WA 98122
Phone (206) 296-5432
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 |
|---|---|---|---|
| A1 60047682 | WA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1235376369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 12TH AVENUE",
"address_2": "PO BOX 222000",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98122",
"telephone_number": "206-296-5432",
"fax_number": "206-296-2154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 12TH AVE",
"address_2": "ATHLETICS BUILDING",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981224411",
"telephone_number": "206-296-5432",
"fax_number": "206-296-2154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSSMAN",
"first_name": "MATTHEW",
"middle_name": "JEROME",
"name_prefix": "Mr.",
"credential": "A.T.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-12",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "A1 60047682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.