Active NPI
Matthew Mills, EDD, LAT, ATC, CHSE
- Athletic Trainer
- Springfield, MA
National Provider Identifier
1780979328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2212
- Practice address
- 263 Alden St
Springfield, MA 01109-3788 - Phone
- (508) 314-2635
- NPI assigned
- Jun 11, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1393 | CT | |
| Athletic Trainer | 2255A2300X | 2212 | MA | Primary |
Addresses
Primary practice location
263 Alden St
Springfield, MA 01109-3788
Mailing address
263 Alden St
Springfield, MA 01109-3788
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 |
|---|---|---|---|
| 2212 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1780979328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 ALDEN ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011093788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 ALDEN ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011093788",
"telephone_number": "508-314-2635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "MATTHEW",
"name_prefix": "Prof.",
"credential": "EDD, LAT, ATC, CHSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-11",
"last_updated": "2024-06-10",
"certification_date": "2024-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "1393",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "2212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.