Active NPI
Grayson Smith
- Athletic Trainer
- Demorest, GA
National Provider Identifier
1407612807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT004695
- Practice address
- 1021 Central Ave
Demorest, GA 30535-5252 - Phone
- (706) 778-3000
- NPI assigned
- Feb 23, 2024
- Sex
- Female
- 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 | AT004695 | GA | Primary |
Addresses
Primary practice location
1021 Central Ave
Demorest, GA 30535-5252
Mailing address
1009 Baldwin Heights Rd
Baldwin, GA 30511-2962
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1407612807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 BALDWIN HEIGHTS RD",
"city": "BALDWIN",
"state": "GA",
"postal_code": "305112962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 CENTRAL AVE",
"city": "DEMOREST",
"state": "GA",
"postal_code": "305355252",
"telephone_number": "706-778-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GRAYSON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-23",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT004695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Demorest, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.