Candice Marie Greathouse

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06003651A Issued in IN

Practice address

3630 Hickory Road
Mishawaka, IN 46545

Phone

(574) 252-7225

NPI assigned

Feb 25, 2019

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1093272114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29272 OLD US 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465149464",
            "telephone_number": "574-220-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 HICKORY ROAD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-252-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREATHOUSE",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003651A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Evelyn Graber, M.D.
• Michael F Grantham, MD
• Kristin Grathen, RN
• Annemarie Catherine Gray, BCBA
• Christie Gray
• Silas Greathouse
• Ashley Griffin
• Russell L Griffing, D.M.D.
• Andrew Ray Griffith
• Carly Grmek, PHARMD

• Physical Therapy Assistant in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.