Individual provider Active NPI

Kathleen Grace, RPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1114977980
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9486 Issued in CA
Practice address
8929 University Center LN
200
San Diego, CA 92122-1006
Phone
(858) 457-3545
Fax
(858) 457-0976
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9486 CA Primary

Addresses

Primary practice location

8929 University Center LN
200
San Diego, CA 92122-1006

Mailing address

11468 Sorrento Valley Rd Ste a
San Diego, CA 92121-1347
Phone (858) 457-3545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120419000739 CA Practitioner - Physical Therapist in Private Practice 7012909203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen J. Grace RPT Apc Physical Therapist CurrentSince May 12, 2017 Accepting new patients
Bryan Schmidt Physical Therapy, Inc Physical Therapist CurrentSince May 12, 2017 Accepting new patients

Locations

11468 Sorrento Valley Rd
Ste A
San Diego, CA 92121
Phone (858) 457-3545

8929 University Center Ln
Ste 200
San Diego, CA 92122
Phone (855) 543-0333

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1114977980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11468 SORRENTO VALLEY RD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211347",
            "telephone_number": "858-457-3545",
            "fax_number": "858-457-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 UNIVERSITY CENTER LN",
            "address_2": "200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221006",
            "telephone_number": "858-457-3545",
            "fax_number": "858-457-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "KATHLEEN",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "9486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.