Individual provider Active NPI

Ashley Grout Hennessee

  • Physical Therapy Assistant
  • Saint Augustine, FL
National Provider Identifier
1033084769
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA27860 Issued in FL
Practice address
150 Mariner Health Way
Saint Augustine, FL 32086-3215
Phone
(904) 584-1827
NPI assigned
Oct 10, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA27860 FL Primary

Addresses

Primary practice location

150 Mariner Health Way
Saint Augustine, FL 32086-3215

Mailing address

150 Mariner Health Way
Saint Augustine, FL 32086-3215
Phone (904) 584-1827

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

LicenseStateTypeSpecialty
PTA27860FLMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1033084769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MARINER HEALTH WAY",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863215",
            "telephone_number": "904-584-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARINER HEALTH WAY",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863215",
            "telephone_number": "904-584-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROUT HENNESSEE",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA27860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.