Matt Elston, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT004190 Issued in PA

Practice address

1350 Broadcasting Rd
Suite 201
Wyomissing, PA 19610-3229

Phone

(610) 685-7200

Fax

(610) 685-6700

NPI assigned

Sep 20, 2009

Sex

Male

Sole proprietor

Yes

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": "1253404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253404800000",
    "number": "1306170691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 GERALD AVE",
            "city": "ORWIGSBURG",
            "state": "PA",
            "postal_code": "179611407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "SUITE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103229",
            "telephone_number": "610-685-7200",
            "fax_number": "610-685-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSTON",
        "first_name": "MATT",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-20",
        "last_updated": "2009-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.