Individual provider Active NPI

Matthew Boyne

  • Athletic Trainer
  • Tulsa, OK
National Provider Identifier
1316331044
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
832 Issued in OK
Practice address
6585 S Yale Ave Ste 200
Tulsa, OK 74136-8315
Phone
(918) 481-2767
Fax
(918) 494-9277
NPI assigned
Mar 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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 832 OK Primary

Addresses

Primary practice location

6585 S Yale Ave Ste 200
Tulsa, OK 74136-8315

Mailing address

6585 S Yale Ave Ste 200
Tulsa, OK 74136-8315
Phone (918) 481-2767

Other practice location 1

13616 E 103rd St N
Owasso, OK 74055-4586
Phone (918) 272-4488

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
832OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1316331044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6585 S YALE AVE STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368315",
            "telephone_number": "918-481-2767",
            "fax_number": "918-494-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6585 S YALE AVE STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368315",
            "telephone_number": "918-481-2767",
            "fax_number": "918-494-9277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13616 E 103rd St N",
            "address_purpose": "LOCATION",
            "city": "Owasso",
            "state": "OK",
            "postal_code": "740554586",
            "country_code": "US",
            "telephone_number": "918-272-4488",
            "fax_number": "918-272-5487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYNE",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OK",
            "license": "832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.