Matthew While, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096001680 Issued in IL

Practice address

135 N Williamsburg Dr
Bloomington, IL 61704-3528

Phone

(309) 661-8823

NPI assigned

Jul 10, 2019

Last updated

Jul 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1619529666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5387",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617025387",
            "telephone_number": "309-661-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N WILLIAMSBURG DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043528",
            "telephone_number": "309-661-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHILE",
        "first_name": "MATTHEW",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096001680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "096001680",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ashley Kay Whitley, COTA/L

• Athletic Trainer in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Athletic Trainer in Illinois

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

Verify at the official NPI Registry.