Active NPI
Nicholas Mataraza
- Athletic Trainer
- Chardon, OH
National Provider Identifier
1669142014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 10727 Clark Rd
Chardon, OH 44024-9779 - Phone
- (440) 622-7381
- NPI assigned
- Sep 16, 2021
- 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 | OH | Primary |
Addresses
Primary practice location
10727 Clark Rd
Chardon, OH 44024-9779
Mailing address
10727 Clark Rd
Chardon, OH 44024-9779
Phone (440) 622-7381
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1669142014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10727 CLARK RD",
"city": "CHARDON",
"state": "OH",
"postal_code": "440249779",
"telephone_number": "440-622-7381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10727 CLARK RD",
"city": "CHARDON",
"state": "OH",
"postal_code": "440249779",
"telephone_number": "440-622-7381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATARAZA",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-16",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chardon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.