Active NPI
Matthew Moreau, LAT, ATC
- Athletic Trainer
- Carrollton, TX
National Provider Identifier
1831514587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT8252
- Practice address
- 4207 Plano Pkwy
Carrollton, TX 75010-4205 - Phone
- (469) 219-7693
- NPI assigned
- Mar 4, 2014
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT8252 | TX | Primary |
Addresses
Primary practice location
4207 Plano Pkwy
Carrollton, TX 75010-4205
Mailing address
4207 Plano Pkwy
Carrollton, TX 75010-4205
Phone (469) 219-7693
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 |
|---|---|---|---|
| AT8252 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650412800000",
"number": "1831514587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 PLANO PKWY",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750104205",
"telephone_number": "469-219-7693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4207 PLANO PKWY",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750104205",
"telephone_number": "469-219-7693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOREAU",
"first_name": "MATTHEW",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-04",
"last_updated": "2022-04-20",
"certification_date": "2022-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT8252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.