Active NPI
Alma Rae Mattocks, ATC
- Athletic Trainer
- Forest Grove, OR
National Provider Identifier
1417098443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-AT-1005014
- Practice address
- 2043 College Way
Forest Grove, OR 97116-1756 - Phone
- (503) 352-2780
- NPI assigned
- Feb 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-AT-1005014 | OR | Primary |
Addresses
Primary practice location
2043 College Way
Forest Grove, OR 97116-1756
Mailing address
Northern Kentucky University
Nunn Drive / HC 116
Highland Heights, KY 41099
Phone (503) 880-0457
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT-AT-1005014 | OR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1417098443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NORTHERN KENTUCKY UNIVERSITY",
"address_2": "NUNN DRIVE / HC 116",
"city": "HIGHLAND HEIGHTS",
"state": "KY",
"postal_code": "41099",
"telephone_number": "503-880-0457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 COLLEGE WAY",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971161756",
"telephone_number": "503-352-2780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOCKS",
"first_name": "ALMA",
"middle_name": "RAE",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "AT-AT-1005014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Grove, OR
- Noah Marek, PT
- Marilyn J Booth MD
- Marquis Companies II, Inc (Marquis Forest Grove Assisted Living)
- Marquis Companies II, Inc. (Marquis Forest Grove Post Acute Rehab)
- Jennifer Renae Martens, DC, LMT
- Deborah Maurseth, DPT
- Sarah Emelia Mawdsley, LPC
- Lori Lynn May, ANP
- Amanda Leigh McCarter
- Celine Martha McCarthy, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.