NPIMap

Organization Active NPI

Ball State University

Doing business as Ball State Sports Medicine

  • Primary Care Nurse Practitioner
  • Muncie, IN
National Provider Identifier
1295137925
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
BALL STATE UNIVERSITY
Doing business as
Ball State Sports Medicine
Interprofessional Community Clinics
Practice address
HB 155
Muncie, IN 47306-0001
Phone
(765) 285-4422
Fax
(765) 285-5623
NPI assigned
Sep 25, 2014
Last updated
Jul 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Blair Scott MatternNPI 1205156155
Title
Associate Dean for Clinical Affairs
Phone
(765) 285-5354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X NU
Audiologist 231H00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

HB 155
Muncie, IN 47306-0001

Mailing address

2000 W University Ave
Muncie, IN 47306-1022
Phone (765) 285-5354

Other names 2

  • Ball State Sports Medicine Doing business as
  • Interprofessional Community Clinics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ball Sate University3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2000 W University Ave
Muncie, IN 47306
Phone (765) 285-4469

HB 155
Muncie, IN 47306

HP 260
Muncie, IN 47306
Phone (765) 285-4469

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1295137925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473061022",
            "telephone_number": "765-285-5354",
            "fax_number": "765-285-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HB 155",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473060001",
            "telephone_number": "765-285-4422",
            "fax_number": "765-285-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALL STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "MATTERN",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ASSOCIATE DEAN FOR CLINICAL AFFAIRS",
        "authorized_official_telephone_number": "765-285-5354"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ball State Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ball State Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Interprofessional Community Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.