Individual provider Active NPI

Matthew D Salmen, MS, ATC, CSCS

  • Athletic Trainer
  • Canton, NY
National Provider Identifier
1619512688
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
002929-1 Issued in NY
Practice address
23 Romoda Dr
Canton, NY 13617-1501
Phone
(315) 229-5835
Fax
(315) 229-5414
NPI assigned
Nov 13, 2019
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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 002929-1 NY Primary

Addresses

Primary practice location

23 Romoda Dr
Canton, NY 13617-1501

Mailing address

23 Romoda Dr
Canton, NY 13617-1501
Phone (315) 229-5835

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
002929-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1619512688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ROMODA DR",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171501",
            "telephone_number": "315-229-5835",
            "fax_number": "315-229-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ROMODA DR",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171501",
            "telephone_number": "315-229-5835",
            "fax_number": "315-229-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMEN",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "MS, ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002929-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.

Verify at the official NPI Registry.