Individual provider Active NPI

Matthew Wayne Smith, ATC

  • Athletic Trainer
  • Cincinnati, OH
National Provider Identifier
1881913770
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
003204 Issued in OH
Practice address
872 Ohio Pike
Cincinnati, OH 45245-2204
Phone
(513) 947-9115
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 003204 OH Primary

Addresses

Primary practice location

872 Ohio Pike
Cincinnati, OH 45245-2204

Mailing address

3868 McMann Rd
Cincinnati, OH 45245-2306
Phone (513) 258-2343

Other practice location 1

3976 N Hampton Dr
Powell, OH 43065-8443
Phone (513) 295-1756

Other practice location 2

2107 Rombach Ave
Wilmington, OH 45177-2099
Phone (513) 843-7716

Other practice location 3

3158 Glenmore Ave
Cincinnati, OH 45211-6449
Phone (513) 843-7716

Other practice location 4

9549 Montgomery Rd Ste 100
Montgomery, OH 45242-7238
Phone (513) 843-7716

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
003204OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Workers Choice Health Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1881913770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3868 MCMANN RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452452306",
            "telephone_number": "513-258-2343",
            "fax_number": "513-718-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 OHIO PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452452204",
            "telephone_number": "513-947-9115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3976 N Hampton Dr",
            "address_purpose": "LOCATION",
            "city": "Powell",
            "state": "OH",
            "postal_code": "430658443",
            "country_code": "US",
            "telephone_number": "513-295-1756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2107 Rombach Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "OH",
            "postal_code": "451772099",
            "country_code": "US",
            "telephone_number": "513-843-7716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3158 Glenmore Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452116449",
            "country_code": "US",
            "telephone_number": "513-843-7716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9549 Montgomery Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452427238",
            "country_code": "US",
            "telephone_number": "513-843-7716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "WAYNE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "003204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.