Individual provider Active NPI

Michael Harry Groves, ATC, LAT

  • Athletic Trainer
  • Stratford, CT
National Provider Identifier
1033651617
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000902 Issued in CT
Practice address
34 Barrows Ter
Stratford, CT 06614-3205
Phone
(203) 257-7390
Fax
(203) 365-6600
NPI assigned
Nov 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 000902 CT Primary

Addresses

Primary practice location

34 Barrows Ter
Stratford, CT 06614-3205

Mailing address

34 Barrows Ter
Stratford, CT 06614-3205
Phone (203) 257-7390

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
000902CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1033651617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 BARROWS TER",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066143205",
            "telephone_number": "203-257-7390",
            "fax_number": "203-365-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BARROWS TER",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066143205",
            "telephone_number": "203-257-7390",
            "fax_number": "203-365-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVES",
        "first_name": "MICHAEL",
        "middle_name": "HARRY",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "000902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.