Active NPI
Brandon Grecinger
- Athletic Trainer
- Tupelo, MS
National Provider Identifier
1841721883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 830 S Gloster St
Tupelo, MS 38801-4934 - Phone
- (662) 377-3000
- NPI assigned
- Mar 22, 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
830 S Gloster St
Tupelo, MS 38801-4934
Mailing address
830 S Gloster St
Tupelo, MS 38801-4934
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000014717 | Other | ATHLETIC TRAINING BOARD OF 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490140800000",
"number": "1841721883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 S GLOSTER ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S GLOSTER ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014934",
"telephone_number": "662-377-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRECINGER",
"first_name": "BRANDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-22",
"last_updated": "2017-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINING BOARD OF CERTIFICATION",
"identifier": "2000014717",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.