Gavin Grosh

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

1588 Issued in AZ

Practice address

15946 N Bullard Ave
Surprise, AZ 85374-8844

Phone

(816) 382-5753

NPI assigned

Apr 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1306333182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15946 N BULLARD AVE",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748844",
            "telephone_number": "816-382-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15946 N BULLARD AVE",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748844",
            "telephone_number": "816-382-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSH",
        "first_name": "GAVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AZ",
            "license": "1588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Griffith
• Gabriela Lynn Grijalva, RBT
• Claudia Grochalska
• Robert Lewis Groesbeck, D.D.S.
• Rachel Evelyn Groff, OD
• Mary Ann Gross
• Roger N Grossbard, O.D.
• Rhea M Grover, EFDA, PTDA
• Grusecki Audiology & Hearing Aid
• Jamie L Grusecki, AU.D.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.