Barry Wyn Grantham II, ATS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

405 Old Town Cir
Brandon, MS 39042-3628

Phone

(601) 720-7446

NPI assigned

Nov 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1487319877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OLD TOWN CIR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423628",
            "telephone_number": "601-720-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OLD TOWN CIR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423628",
            "telephone_number": "601-720-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "BARRY",
        "middle_name": "WYN",
        "name_suffix": "II",
        "credential": "ATS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica F Graham, SLP
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• Zoe Amoret Grasee-Slenning, PT, DPT
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• Student in an Organized Health Care Education/Training Program in Brandon, MS
• Providers in Brandon, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.