Individual provider Active NPI

Gregory George Bozeka, LAT

  • Athletic Trainer
  • Athens, OH
National Provider Identifier
1508838046
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
002630 Issued in OH
Practice address
Ohio University
Grover E207
Athens, OH 45701-2979
Phone
(740) 593-9497
NPI assigned
Feb 7, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 002630 OH Primary

Addresses

Primary practice location

Ohio University
Grover E207
Athens, OH 45701-2979

Mailing address

217 Cordelia St SW
North Canton, OH 44720-3503
Phone (330) 497-7295

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
002630OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508838046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 CORDELIA ST SW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447203503",
            "telephone_number": "330-497-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OHIO UNIVERSITY",
            "address_2": "GROVER E207",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012979",
            "telephone_number": "740-593-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZEKA",
        "first_name": "GREGORY",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "002630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.