Active NPI
Kyle Groves, ATC
- Athletic Trainer
- Granville, OH
National Provider Identifier
1154130730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT005062
- Practice address
- 200 Livingston Dr
Granville, OH 43023 - Phone
- (567) 224-1330
- NPI assigned
- Jan 7, 2025
- 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 | AT005062 | OH | Primary |
Addresses
Primary practice location
200 Livingston Dr
Granville, OH 43023
Mailing address
972 Mount Vernon Rd
Newark, OH 43055-4729
Phone (567) 224-1330
Other practice location 1
972 Mount Vernon Rd
Newark, OH 43055-4729
Phone (567) 224-1330
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 |
|---|---|---|---|
| AT005062 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1154130730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "972 MOUNT VERNON RD",
"city": "NEWARK",
"state": "OH",
"postal_code": "430554729",
"telephone_number": "567-224-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 LIVINGSTON DR",
"city": "GRANVILLE",
"state": "OH",
"postal_code": "43023",
"telephone_number": "567-224-1330"
}
],
"practiceLocations": [
{
"address_1": "972 Mount Vernon Rd",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "OH",
"postal_code": "430554729",
"country_code": "US",
"telephone_number": "567-224-1330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GROVES",
"first_name": "KYLE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-07",
"last_updated": "2025-01-07",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT005062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.