Individual provider Active NPI

Matthew T Husnik, LAT

  • Athletic Trainer
  • Oshkosh, WI
National Provider Identifier
1558544726
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
938-039 Issued in WI
Practice address
2725 Jackson St
Oshkosh, WI 54901-1513
Phone
(920) 209-1381
NPI assigned
Dec 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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 938-039 WI Primary

Addresses

Primary practice location

2725 Jackson St
Oshkosh, WI 54901-1513

Mailing address

1380A Ceape Ave
Oshkosh, WI 54901-5426
Phone (319) 560-4212

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
938-039WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1558544726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380A CEAPE AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549015426",
            "telephone_number": "319-560-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 JACKSON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011513",
            "telephone_number": "920-209-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSNIK",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "938-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.