Individual provider Active NPI

Adam Russell Groves, D.P.T.

  • Physical Therapist
  • Bozeman, MT
National Provider Identifier
1770865503
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2472PT Issued in MT
Practice address
1125 W Kagy Blvd Ste 101a
Bozeman, MT 59715-5879
Phone
(406) 556-0562
Fax
(406) 556-0965
NPI assigned
Sep 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2472PT MT Primary

Addresses

Primary practice location

1125 W Kagy Blvd Ste 101a
Bozeman, MT 59715-5879

Mailing address

1125 W Kagy Blvd Ste 101a
Bozeman, MT 59715-5879
Phone (406) 556-0562

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

LicenseStateTypeSpecialty
2472PTMTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Provision Physical Therapy CurrentSince Jul 30, 2012 Accepting new patients
Excel Orthopedic Physical Therapy Limited Partnership Physical Therapist PastSince Oct 1, 2022 Accepting new patients

Locations

1400 Dowell Springs Blvd
Ste 120
Knoxville, TN 37909
Phone (865) 232-1415

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1770865503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 101A",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-556-0562",
            "fax_number": "406-556-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 101A",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-556-0562",
            "fax_number": "406-556-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVES",
        "first_name": "ADAM",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-19",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "2472PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.