Individual provider Active NPI

Matthew Stuart Craven, LAT, ATC

  • Athletic Trainer
  • Greensboro, NC
National Provider Identifier
1306246590
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2154 Issued in NC
Practice address
4009 Eight Belles LN
Apt 3H
Greensboro, NC 27410-9879
Phone
(336) 707-1492
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2154 NC Primary

Addresses

Primary practice location

4009 Eight Belles LN
Apt 3H
Greensboro, NC 27410-9879

Mailing address

4009 Eight Belles LN
Apt 3H
Greensboro, NC 27410-9879
Phone (336) 707-1492

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

LicenseStateTypeSpecialty
2154NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1306246590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 EIGHT BELLES LN",
            "address_2": "APT 3H",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109879",
            "telephone_number": "336-707-1492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 EIGHT BELLES LN",
            "address_2": "APT 3H",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109879",
            "telephone_number": "336-707-1492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "MATTHEW",
        "middle_name": "STUART",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.