Matthew Benjamin Bass, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0000886 Issued in MD

Practice address

81 W Frederick St
Walkersville, MD 21793-8216

Phone

(301) 910-1025

NPI assigned

Jan 27, 2020

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

State licenses

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1295366433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 THOMAS JOHNSON DR STE 180",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024509",
            "telephone_number": "301-620-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W FREDERICK ST",
            "city": "WALKERSVILLE",
            "state": "MD",
            "postal_code": "217938216",
            "telephone_number": "301-910-1025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Shorebird St Ste B",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217011962",
            "country_code": "US",
            "telephone_number": "855-748-4868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024502",
            "country_code": "US",
            "telephone_number": "301-620-7478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASS",
        "first_name": "MATTHEW",
        "middle_name": "BENJAMIN",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Walkersville, MD
• Providers in Walkersville, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.