Active NPI
Matthew Krill, ATC
- Athletic Trainer
- Columbus, OH
National Provider Identifier
1982129623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 555 Borror Dr
Columbus, OH 43210 - Phone
- (614) 688-3939
- NPI assigned
- Aug 3, 2017
- Reactivated
- Jan 2, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
555 Borror Dr
Columbus, OH 43210
Mailing address
222 W Lane Ave Apt 904
Columbus, OH 43201-4373
Other practice location 1
2835 Fred Taylor Dr
Columbus, OH 43202-1552
Phone (360) 931-8340
Other practice location 2
2835 Fred Taylor Dr
Columbus, OH 43202-1552
Phone (360) 931-8340
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593648000000",
"number": "1982129623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 W LANE AVE APT 904",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432014373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 BORROR DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43210",
"telephone_number": "614-688-3939"
}
],
"practiceLocations": [
{
"address_1": "2835 Fred Taylor Dr",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432021552",
"country_code": "US",
"telephone_number": "360-931-8340",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2835 Fred Taylor Dr",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432021552",
"country_code": "US",
"telephone_number": "360-931-8340",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRILL",
"first_name": "MATTHEW",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-03",
"last_updated": "2020-07-02",
"certification_date": "2020-07-02",
"deactivation_date": "2017-12-05",
"reactivation_date": "2019-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.