Active NPI
Matthew H Wolfe, ATC, NREMT-B
- Athletic Trainer
- Randall, IA
National Provider Identifier
1689686354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL1891
- Practice address
- 640 Main St
Randall, IA 50231-7708 - Phone
- (407) 506-4971
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | AL1891 | FL | Primary |
Addresses
Primary practice location
640 Main St
Randall, IA 50231-7708
Mailing address
PO Box 5
Randall, IA 50231-0005
Phone (407) 506-4971
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
| License | State | Type | Specialty |
|---|---|---|---|
| AL1891 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238976000000",
"number": "1689686354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5",
"city": "RANDALL",
"state": "IA",
"postal_code": "502310005",
"telephone_number": "407-506-4971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 MAIN ST",
"city": "RANDALL",
"state": "IA",
"postal_code": "502317708",
"telephone_number": "407-506-4971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFE",
"first_name": "MATTHEW",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "ATC, NREMT-B",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2009-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL1891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.