Active NPI
Matthew Mitchell, ATC
- Athletic Trainer
- Villanova, PA
National Provider Identifier
1861186447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT006152
- Practice address
- 800 E Lancaster Ave
Villanova, PA 19085-1603 - Phone
- (610) 519-4594
- Fax
- (610) 519-7728
- NPI assigned
- Jun 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | RT006152 | PA | Primary |
Addresses
Primary practice location
800 E Lancaster Ave
Villanova, PA 19085-1603
Mailing address
7251 N 21St St
Philadelphia, PA 19138-2101
Phone (215) 869-9910
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 |
|---|---|---|---|
| RT006152 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1861186447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7251 N 21ST ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191382101",
"telephone_number": "215-869-9910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E LANCASTER AVE",
"city": "VILLANOVA",
"state": "PA",
"postal_code": "190851603",
"telephone_number": "610-519-4594",
"fax_number": "610-519-7728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "MATTHEW",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-06",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT006152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villanova, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.