NPIMap

Organization Active NPI

Georgia Southern University

  • Athletic Trainer
  • Statesboro, GA
National Provider Identifier
1760353072
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
GEORGIA SOUTHERN UNIVERSITY
Practice address
Hanner Field House
590 Herty Drive Room 1216C
Statesboro, GA 30460-1000
Phone
(912) 531-1436
Fax
(912) 478-1017
NPI assigned
Sep 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Matthew Massar
Title
Authorized Official
Phone
(847) 250-5470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X Primary

Addresses

Primary practice location

Hanner Field House
590 Herty Drive Room 1216C
Statesboro, GA 30460-1000

Mailing address

PO Box 8082
Statesboro, GA 30460-1000

National Provider Directory

National Provider Directory
Tax ID family
Georgia Southern University School of Nursing Community Nursing Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1760353072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8082",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304601000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HANNER FIELD HOUSE",
            "address_2": "590 HERTY DRIVE ROOM 1216C",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304601000",
            "telephone_number": "912-531-1436",
            "fax_number": "912-478-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SOUTHERN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "MASSAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "847-250-5470"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.