Matthew Weisenberger, ATC
Specialist/Technologist, Athletic Trainer in Tupelo, MS. Individual provider (NPI-1).
NPI number1366645558
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1366645558
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matthew Weisenberger
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 6, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT 0143 | MS | Yes |
Practice location
4381 S Eason BlvdTupelo, MS 38801-6583
Phone 662-377-7215
Mailing address
124 County Road 131Tupelo, MS 38804
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Athletic Trainer providers in Tupelo, MS
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- Brandon GrecingerNPI 1841721883
- Ruth A. Haugan, ATCNPI 1144205774
- Mark L. Porter, ATCNPI 1457478828
- Michelle PruittNPI 1003233727
- Stephen ThompsonNPI 1730726530
- Philip Weivoda, ATCNPI 1588329775
- Donna Elaine Wesley, ATCNPI 1548259013
- Amy Michelle Whitley, ATCNPI 1437352853
All 14 Athletic Trainer providers in Tupelo · All 2,880 providers in Tupelo
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