Active NPI
John David Grantham, PT
- Physical Therapist
- Knoxville, TN
National Provider Identifier
1548355415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT0000002049
- Practice address
- 2120 Highland Ave
Knoxville, TN 37916 - Phone
- (865) 525-4131
- Fax
- (865) 523-0086
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0000002049 | TN | Primary |
Addresses
Primary practice location
2120 Highland Ave
Knoxville, TN 37916
Mailing address
141 Pleasant Rd
Clinton, TN 37716
Phone (865) 457-8712
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0000002049 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548355415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 PLEASANT RD",
"city": "CLINTON",
"state": "TN",
"postal_code": "37716",
"telephone_number": "865-457-8712",
"fax_number": "865-523-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 HIGHLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37916",
"telephone_number": "865-525-4131",
"fax_number": "865-523-0086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANTHAM",
"first_name": "JOHN",
"middle_name": "DAVID",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT0000002049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Knoxville, TN
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.