Active NPI
Bryce Gimmarro, LAT, ATC
- Athletic Trainer
- Gainesville, FL
National Provider Identifier
1003467291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL6014
- Practice address
- 290 Woodlawn Dr
Gainesville, FL 32611-1949 - Phone
- (734) 664-8861
- NPI assigned
- Sep 27, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL6014 | FL | Primary |
Addresses
Primary practice location
290 Woodlawn Dr
Gainesville, FL 32611-1949
Mailing address
1680 Harter Way
The Villages, FL 32163-5318
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL6014 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1003467291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 HARTER WAY",
"city": "THE VILLAGES",
"state": "FL",
"postal_code": "321635318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 WOODLAWN DR",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326111949",
"telephone_number": "734-664-8861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIMMARRO",
"first_name": "BRYCE",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-27",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL6014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.