Matthew Gervasi

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

13447 Staff Sargent Sims St
Fort Bliss, TX 79918

Phone

(609) 828-8128

NPI assigned

Feb 8, 2022

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1437803418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LAFAYETTE RD",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "081061130",
            "telephone_number": "609-828-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13447 STAFF SARGENT SIMS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "79918",
            "telephone_number": "609-828-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138 Lafayette Rd",
            "address_purpose": "LOCATION",
            "city": "Audubon",
            "state": "NJ",
            "postal_code": "081061130",
            "country_code": "US",
            "telephone_number": "609-828-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERVASI",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph William Garcia, FNP-C
• Juan Aurelio Francisco Garcia, ATC
• Kathryn Mier Garcia, PHARMD
• Kristen Garvie, MD
• Danielle Mercedes Gasca-Marquez, RDH
• Tyler E Gibbons, O.D.
• Jan Marie Gibson
• Lauren Gibson, LCSW
• Kathy Megler Gilyard, PH.D.
• Allen Gladieux

• Athletic Trainer in Fort Bliss, TX
• Providers in Fort Bliss, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.