Individual provider Active NPI

Jordan Faith Matthews

  • Athletic Trainer
  • Cedar City, UT
National Provider Identifier
1770367229
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
14152266-4810 Issued in UT
Practice address
351 W University Blvd # 106
Cedar City, UT 84720-2418
Phone
(435) 865-8354
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X 14152266-4810 UT Primary

Addresses

Primary practice location

351 W University Blvd # 106
Cedar City, UT 84720-2418

Mailing address

668 E Fiddlers Cove Dr Unit 52
Cedar City, UT 84721-9768
Phone (270) 872-9501

Other practice location 1

3630 Little Rock Dr
Provo, UT 84604-5261
Phone (270) 872-9501

Other identifiers 1

IdentifierTypeStateIssuer
2000056553OtherBOC

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
14152266-4810UTMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1770367229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 E FIDDLERS COVE DR UNIT 52",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847219768",
            "telephone_number": "270-872-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W UNIVERSITY BLVD # 106",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847202418",
            "telephone_number": "435-865-8354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3630 Little Rock Dr",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846045261",
            "country_code": "US",
            "telephone_number": "270-872-9501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "JORDAN",
        "middle_name": "FAITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": "14152266-4810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000056553",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.