Individual provider Active NPI

Matthew Esposito, LAT, ATC

  • Athletic Trainer
  • Virginia Beach, VA
National Provider Identifier
1669137196
Registry record updated Oct 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126003471 Issued in VA
Practice address
4435 Virginia Beach Blvd
Virginia Beach, VA 23462-3100
Phone
(757) 252-0590
NPI assigned
Oct 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2021

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 0126003471 VA Primary

Addresses

Primary practice location

4435 Virginia Beach Blvd
Virginia Beach, VA 23462-3100

Mailing address

3125 Tidal Bay LN
Virginia Beach, VA 23451-1147
Phone (757) 575-5311

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
0126003471VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1635638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1669137196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 TIDAL BAY LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511147",
            "telephone_number": "757-575-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623100",
            "telephone_number": "757-252-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "MATTHEW",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-31",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126003471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2021; 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.