Kathleen Michelle Graves, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 28488 Issued in CA

Practice address

1716 W Hammer LN
Stockton, CA 95209-2922

Phone

(209) 473-2383

Fax

(209) 473-1350

NPI assigned

Jul 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sutter Gould Medical Foundation

  dba Dale Road Care Center

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1326093360
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1063602894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423532",
            "telephone_number": "209-368-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922",
            "telephone_number": "209-473-2383",
            "fax_number": "209-473-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "KATHLEEN",
        "middle_name": "MICHELLE",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 28488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Grassi
• Mark Werner Grassinger, LCSW
• Andrew Colin Grauer
• Elizabeth Maria Graumann, PHARM.D.
• Daniel Graves, P.T.
• Gisela Larthea Gray-Peoples
• Angelique Deann Gray
• Gary A. Gray, PT
• Jalisha E Gray
• Jennifer A. Gray, MD

• Physical Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.