Active NPI
Paul R Musgrove, ATC/L, CSCS,
- Athletic Trainer
- Fort Campbell, KY
National Provider Identifier
1720167984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 101
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (931) 920-4644
- NPI assigned
- Nov 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT366 | KY | |
| Athletic Trainer | 2255A2300X | 101 | TN | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
650 Joel Dr
Fort Campbell, KY 42223-5318
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101 | Other | TN | STATE OF TN MEDICAL BOARDS |
| 000090496 | Other | NATIONAL CERTIFICATION |
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT366 | KY | MD | Athletic Trainer |
| 101 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1720167984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "931-920-4644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSGROVE",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "ATC/L, CSCS,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KY",
"license": "AT366",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "101",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF TN MEDICAL BOARDS",
"identifier": "101",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFICATION",
"identifier": "000090496",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.