Active NPI
Annie Kannenpla Verghese
- Physical Therapist
- Sacramento, CA
National Provider Identifier
1053505164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18310
- Practice address
- 2315 Stockton Blvd
Sacramento, CA 95817-2201 - Phone
- (916) 734-7248
- NPI assigned
- Aug 31, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 18310 | CA | Primary |
Addresses
Primary practice location
2315 Stockton Blvd
Sacramento, CA 95817-2201
Mailing address
233 Briggs Ranch Dr
Folsom, CA 95630-5269
Phone (626) 807-7906
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 |
|---|---|---|---|
| 18310 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188518400000",
"number": "1053505164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 BRIGGS RANCH DR",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956305269",
"telephone_number": "626-807-7906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172201",
"telephone_number": "916-734-7248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGHESE",
"first_name": "ANNIE",
"middle_name": "KANNENPLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2007-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "18310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.