Individual provider Active NPI

Jarod Scott Grace, ATC

  • Athletic Trainer
  • Auburn, AL
National Provider Identifier
1164632618
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
719 Issued in AL
Practice address
651 Roosevelt Dr
Auburn, AL 36849-5322
Phone
(334) 844-9829
Fax
(334) 844-0295
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 719 AL Primary

Addresses

Primary practice location

651 Roosevelt Dr
Auburn, AL 36849-5322

Mailing address

651 Roosevelt Dr
Auburn, AL 36849-5322
Phone (334) 844-9829

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
719ALMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164632618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ROOSEVELT DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368495322",
            "telephone_number": "334-844-9829",
            "fax_number": "334-844-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 ROOSEVELT DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368495322",
            "telephone_number": "334-844-9829",
            "fax_number": "334-844-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "JAROD",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.