Matthew Brannon, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT007123 Issued in PA

Practice address

4930 Starboard Cir Apt 108
Mechanicsburg, PA 17050-3242

Phone

(850) 419-1400

NPI assigned

Jan 11, 2021

Last updated

Jan 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1902495369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 STARBOARD CIR APT 108",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503242",
            "telephone_number": "850-419-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 STARBOARD CIR APT 108",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503242",
            "telephone_number": "850-419-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "MATTHEW",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT007123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RT007123",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000033950",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Paige Brady
• Hannah Jane Brancaleone, PA-C
• Branch Medical Clinic Mechanicsburg
• Kyra Branch
• Melissa Brandt, COTA/L, CTRS
• Navdeep K Brar, M.D.
• Jennifer Braun
• Justin Robert Brautigam, PT, DPT, ATC
• Angel-Grace Bravo
• Tara Breitsprecher

• Athletic Trainer in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.