Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Matthew Edwin Wallace, ATC, PES

Individual provider Athletic Trainer · NPI 1760426258

Mr. Matthew Edwin Wallace, ATC, PES is an Athletic Trainer in Omaha, Nebraska. Licensed in Nebraska. Registered with an NPI since 2006.

Licensed in
NE
In the registry since
2006
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Partly verified

Some contact details are missing from the federal record.

Creighton Uniuversity 2500 California Plz
Omaha, NE 68178-0001
Phone: (402) 280-5563
Fax: (402) 280-3110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 378 (NE)

Record details

NPI number1760426258
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , PES
Sole proprietorNo
NPI enumeratedJune 15, 2006
Last updated in NPPESJuly 13, 2026

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