Individual provider Active NPI

Matthew McGraw, ATC

  • Athletic Trainer
  • Gulf Breeze, FL
National Provider Identifier
1386095404
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL3167 Issued in FL
Practice address
1040 Gulf Breeze Pkwy
Suite 101
Gulf Breeze, FL 32561-7809
Phone
(850) 916-8671
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1428 AL
Athletic Trainer 2255A2300X AL3167 FL Primary

Addresses

Primary practice location

1040 Gulf Breeze Pkwy
Suite 101
Gulf Breeze, FL 32561-7809

Mailing address

1000 W Moreno St
Pensacola, FL 32501-2316

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
AL3167FLMDAthletic Trainer
1428ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrews Institute Rehabilitation, LLC PastSince Feb 2, 2020 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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1386095404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W MORENO ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325012316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "SUITE 101",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617809",
            "telephone_number": "850-916-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "1428",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.