Individual provider Active NPI

Robert Allen Grobmyer, PTA

  • Physical Therapy Assistant
  • Dayton, OH
National Provider Identifier
1104666775
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA008651 Issued in OH
Practice address
323 Forest Ave
Dayton, OH 45405-4599
Phone
(937) 224-0793
NPI assigned
May 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 PTA008651 OH Primary

Addresses

Primary practice location

323 Forest Ave
Dayton, OH 45405-4599

Mailing address

1159 Belvoir Ave
Dayton, OH 45409-1428
Phone (937) 572-8879

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
PTA008651OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1104666775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 BELVOIR AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091428",
            "telephone_number": "937-572-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 FOREST AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054599",
            "telephone_number": "937-224-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROBMYER",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA008651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.