Individual provider Active NPI

Gracie Ann Schroen, PTA

  • Physical Therapy Assistant
  • Ellicott City, MD
National Provider Identifier
1093086639
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A3021 Issued in MD
Practice address
3000 N Ridge Rd
Ellicott City, MD 21043-3311
Phone
(410) 461-7577
NPI assigned
Jan 12, 2012
Last updated
Jan 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A3021 MD Primary

Addresses

Primary practice location

3000 N Ridge Rd
Ellicott City, MD 21043-3311

Mailing address

620 Green Valley Way
Sykesville, MD 21784-8517
Phone (410) 549-4758

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

LicenseStateTypeSpecialty
A3021MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1093086639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GREEN VALLEY WAY",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217848517",
            "telephone_number": "410-549-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N RIDGE RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433311",
            "telephone_number": "410-461-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEN",
        "first_name": "GRACIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A3021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.