Active NPI
Matthew Martin, ATC
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Sheboygan, WI
National Provider Identifier
1720724495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- ATH.200397
- Practice address
- 3411 N 6TH St
Sheboygan, WI 53083-3104 - Phone
- (208) 874-2994
- NPI assigned
- May 6, 2022
- 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 |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | ATH.200397 | LA | Primary |
Addresses
Primary practice location
3411 N 6TH St
Sheboygan, WI 53083-3104
Mailing address
3411 N 6TH St
Sheboygan, WI 53083-3104
Phone (208) 874-2994
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 |
|---|---|---|---|
| ATH.200397 | LA | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651795200000",
"number": "1720724495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3411 N 6TH ST",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530833104",
"telephone_number": "208-874-2994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3411 N 6TH ST",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530833104",
"telephone_number": "208-874-2994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MATTHEW",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-06",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "LA",
"license": "ATH.200397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.