Phillip Mateja, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT64 Issued in ME

Practice address

Brewer High School
79 Parkway South
Brewer, ME 04412

Phone

(207) 989-4140

NPI assigned

Feb 26, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952437667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 PINE ST",
            "city": "ORONO",
            "state": "ME",
            "postal_code": "044734049",
            "telephone_number": "207-866-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BREWER HIGH SCHOOL",
            "address_2": "79 PARKWAY SOUTH",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-989-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEJA",
        "first_name": "PHILLIP",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT64",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Manzerova, M.D./PH.D.
• Manzo Corporation
• Melanie Marie Marchman, LCSW
• Matthew Jay Marston Jr., PHARM.D.
• Sara Maureen Martin, M.A., CCC-SLP
• Subha Mazzone, M.D.
• Jody McCannell, SLP
• Kristi McGown, PT
• Kevin McGrady, PHARMD
• McKay Counseling PLLC

• Athletic Trainer in Brewer, ME
• Providers in Brewer, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.