NPIMap

Organization Active NPI

Georgia Southern University

  • Athletic Trainer
  • Statesboro, GA
National Provider Identifier
1871440404
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
GEORGIA SOUTHERN UNIVERSITY
Practice address
Ted Smith Family Football Center
205 Lanier Drive
Statesboro, GA 30458-1524
Phone
(912) 478-5509
NPI assigned
Mar 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Matthew Masar
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

Ted Smith Family Football Center
205 Lanier Drive
Statesboro, GA 30458-1524

Mailing address

205 Lanier Dr
Statesboro, GA 30458-1524
Phone (912) 478-5509

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1871440404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LANIER DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581524",
            "telephone_number": "912-478-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TED SMITH FAMILY FOOTBALL CENTER",
            "address_2": "205 LANIER DRIVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581524",
            "telephone_number": "912-478-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SOUTHERN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "MASAR",
        "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 Mar 12, 2026; 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.