Jacob Wesley Groseth, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT33205 Issued in FL

Practice address

463688 State Road 200 Ste 9
Yulee, FL 32097-0304

Phone

(904) 261-4414

NPI assigned

Nov 4, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Jake Groseth Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1881023539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463688 STATE ROAD 200 STE 9",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320970304",
            "telephone_number": "904-261-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSETH",
        "first_name": "JACOB",
        "middle_name": "WESLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "145866",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PT33205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "GROSETH",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Aubrey Griffith
• Meredith Grissom, M.S., CF-SLP
• Frank Marcus Gupton, DDS
• Linda Gurt, LMHC
• Katherine Augustina Gusman, BT
• Hair Arete LLC
• Rachel Haisten

• Physical Medicine & Rehabilitation Physician in Yulee, FL
• Providers in Yulee, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.

Verify at the official NPI Registry.