Active NPI
Jeremy Gronos, DPT
- Physical Therapist
- Radford, VA
National Provider Identifier
1922412055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305206615
- Practice address
- 600-A East Main Street
Suite a
Radford, VA 24141 - Phone
- (540) 633-0413
- Fax
- (540) 633-0416
- NPI assigned
- Jun 17, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305206615 | VA | Primary |
| Physical Therapist | 225100000X | PT011360 | GA | |
| Physical Therapist | 225100000X | 070018224 | IL | |
| Physical Therapist | 225100000X | PT60290286 | WA | |
| Physical Therapist | 225100000X | 5501016344 | MI |
Addresses
Primary practice location
600-A East Main Street
Suite a
Radford, VA 24141
Mailing address
600-A East Main St
Suite a
Radford, VA 24141
Phone (540) 633-0413
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT011360 | GA | MD | Physical Therapist |
| 070018224 | IL | MD | Physical Therapist |
| 5501016344 | MI | MD | Physical Therapist |
| 2305206615 | VA | MD | Physical Therapist |
| PT60290286 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402963200000",
"number": "1922412055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600-A EAST MAIN ST",
"address_2": "SUITE A",
"city": "RADFORD",
"state": "VA",
"postal_code": "24141",
"telephone_number": "540-633-0413",
"fax_number": "540-633-0416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600-A EAST MAIN STREET",
"address_2": "SUITE A",
"city": "RADFORD",
"state": "VA",
"postal_code": "24141",
"telephone_number": "540-633-0413",
"fax_number": "540-633-0416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRONOS",
"first_name": "JEREMY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-17",
"last_updated": "2014-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305206615",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011360",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070018224",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60290286",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501016344",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Radford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.