Individual provider Active NPI

Geena Marie Grattan, ATC

  • Athletic Trainer
  • Keuka Park, NY
National Provider Identifier
1578073516
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
002695-1 Issued in NY
Practice address
141 Central Ave
Keuka Park, NY 14478-9764
Phone
(315) 279-5000
Fax
(315) 279-5000
NPI assigned
Oct 4, 2017
Last updated
Oct 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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 002695-1 NY Primary

Addresses

Primary practice location

141 Central Ave
Keuka Park, NY 14478-9764

Mailing address

1 Hickory St
Keuka Park, NY 14478-9605
Phone (585) 813-3842

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
002695-1NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
FLH Medical, PC Past Accepting new patients
FLH Medical, PC Single Specialty Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1578073516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HICKORY ST",
            "city": "KEUKA PARK",
            "state": "NY",
            "postal_code": "144789605",
            "telephone_number": "585-813-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 CENTRAL AVE",
            "city": "KEUKA PARK",
            "state": "NY",
            "postal_code": "144789764",
            "telephone_number": "315-279-5000",
            "fax_number": "315-279-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATTAN",
        "first_name": "GEENA MARIE",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002695-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keuka Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.