Matthew Ridgway, MED, ATC, LAT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

2018029283 Issued in MO

Practice address

100 Missouri Athletics Training Complex
Columbia, MO 65211-0001

Phone

(573) 253-4564

NPI assigned

Apr 22, 2021

Last updated

Apr 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1255913059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MISSOURI ATHLETICS TRAINING COMPLEX",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652110001",
            "telephone_number": "573-253-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MISSOURI ATHLETICS TRAINING COMPLEX",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652110001",
            "telephone_number": "573-253-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGWAY",
        "first_name": "MATTHEW",
        "credential": "MED, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MO",
            "license": "2018029283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Leann Richter, C.R.N.A.
• Rick Rother, P.T., P.C.
• John Anthony Rickards, MD
• Ride Care LLC
• Isabelle Claire Ridgeway, MS
• Blake Steven Riebe, D.O.
• Kimberly Jean Riebe, FNP/MSN
• Allison Riechmann, PHARMD
• Frank G Rieger, MD
• David R Ries, DDS

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.