MR. RANDELL GENE MATTHEWS (NPI# 1487622403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487622403 |
| Entity Type | Individual |
| Full Name | MR. RANDELL GENE MATTHEWS |
| Credential | ATC., LAT |
| Practice Address |
3501 Knickerbocker Rd San Angelo TX 76904-7610 |
| Mailing Address |
3107 Hemlock Dr San Angelo TX 76904-6118 |
| Practice Telephone | 3259494357 |
| Practice Fax Number | 3252245911 |
| Mailing Telephone | 3259443688 |
| Mailing Fax Number | 3252245911 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT0374 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3501 KNICKERBOCKER RD |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-7610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700231248 | Kyle Mills | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-05-03 |
| 1710341508 | Anthony Mcdonald | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-04-08 |
| 1972966000 | Yotham Fraenkel | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-04-05 |
| 1386012037 | Crystal Sustaita | Nurse Anesthetist, Certified Registered | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2015-09-11 |
| 1659769198 | Joe Riley Mcfarland | Nurse Anesthetist, Certified Registered | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2015-01-07 |
| 1154748671 | Caesasonia Pascual Agatep | Nurse Practitioner | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2014-03-21 |
| 1588009807 | San Angelo Emergency Medicine Associates Pa | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-30 |
| 1982048682 | Crystal Collin Kirkland | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-24 |
| 1457606154 | Oasis of West Tx Emergency | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2012-07-18 |
| 1619231511 | Jumano Emergency Physicians | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2012-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1184097222 | Kristi Mae White | Specialist/Technologist | 2412 W Twohig Ave, San Angelo, TX 76901-3729 | 2015-11-11 |
| 1629333026 | Scott Emerson Itz | Specialist/Technologist | 3017 Tanglewood Dr, San Angelo, TX 76904-6139 | 2012-07-11 |
| 1033479076 | Sherry Ann Miller | Specialist/Technologist | 2601 W Avenue N, San Angelo, TX 76909-2601 | 2012-05-24 |
| 1588940134 | Kelcey Cottle Vanderburg | Specialist/Technologist | 900 E 43rd St, San Angelo, TX 76903-1845 | 2011-10-27 |
| 1174622187 | John Jeff Pulley | Specialist/Technologist | 115 W 1st St, San Angelo, TX 76903-5770 | 2006-09-22 |
| 1295798551 | Steven Robert Snowden | Specialist/Technologist | Asu Station# 10903, San Angelo, TX 76909-0001 | 2006-04-08 |
| 1316506595 | Jacob Josiah Stockland | Specialist/Technologist | 2237 S. Jackson, San Angelo, TX 76904 | 2019-06-11 |
| 1497233134 | Brittney Hughes | Specialist/Technologist | 3605 Executive Dr, San Angelo, TX 76904-6884 | 2018-08-03 |
| 1396280921 | Vance Gohlke | Specialist/Technologist | 4450 Sunset Dr, San Angelo, TX 76901-5611 | 2017-01-06 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.