Active NPI
Randell Gene Matthews, ATC., LAT
- Athletic Trainer
- San Angelo, TX
National Provider Identifier
1487622403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0374
- Practice address
- 3501 Knickerbocker Rd
San Angelo, TX 76904-7610 - Phone
- (325) 949-4357
- Fax
- (325) 224-5911
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- 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 | AT0374 | TX | Primary |
Addresses
Primary practice location
3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Mailing address
3107 Hemlock Dr
San Angelo, TX 76904-6118
Phone (325) 944-3688
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 |
|---|---|---|---|
| AT0374 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1487622403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3107 HEMLOCK DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769046118",
"telephone_number": "325-944-3688",
"fax_number": "325-224-5911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 KNICKERBOCKER RD",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769047610",
"telephone_number": "325-949-4357",
"fax_number": "325-224-5911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "RANDELL",
"middle_name": "GENE",
"name_prefix": "Mr.",
"credential": "ATC., LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT0374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.