Active NPI
Dominic Joseph Gradozzi III
- Athletic Trainer
- Beaumont, TX
National Provider Identifier
1760911770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 211 Redbird LN
Beaumont, TX 77705-9801 - Phone
- (409) 880-7011
- NPI assigned
- Jun 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
211 Redbird LN
Beaumont, TX 77705-9801
Mailing address
6050 Townhouse LN
Beaumont, TX 77707-1843
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lamar University | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496620800000",
"number": "1760911770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6050 TOWNHOUSE LN",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777071843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 REDBIRD LN",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777059801",
"telephone_number": "409-880-7011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADOZZI",
"first_name": "DOMINIC",
"middle_name": "JOSEPH",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-05",
"last_updated": "2017-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
- Dianna Tingle Gould, AUD
- Hannah Gower, LVN
- Grace & Mercy Missionary Baptist Church
- Grace Healthcare Staffing Agency (Grace Health Solutions)
- Connie R Gradney, LBSW
- Brianna Lee Graffagnino, LMT
- Jordan Brett Graffagnino, LSA, CSFA
- Lacey N Graffagnino, LSA
- Clancie Calais Grant, RPH
- Shawn Rooney Gray, MSN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.