Individual provider Active NPI

Alisha Grisby

  • Athletic Trainer
  • Oklahoma City, OK
National Provider Identifier
1760849350
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT6846 Issued in TX
Practice address
11605 Copper Trails LN
Oklahoma City, OK 73170-4486
Phone
(405) 496-0770
NPI assigned
Jan 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT6846 TX Primary
Athletic Trainer 2255A2300X 640 OK

Addresses

Primary practice location

11605 Copper Trails LN
Oklahoma City, OK 73170-4486

Mailing address

11605 Copper Trails LN
Oklahoma City, OK 73170-4486
Phone (405) 496-0770

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
AT6846TXMDAthletic Trainer
640OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1760849350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 COPPER TRAILS LN",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731704486",
            "telephone_number": "405-496-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 COPPER TRAILS LN",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731704486",
            "telephone_number": "405-496-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISBY",
        "first_name": "ALISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6846",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OK",
            "license": "640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.