Active NPI
Donna Browder Grace, P.T.
- Physical Therapist
- St Augustine, FL
National Provider Identifier
1114978756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT28203
- Practice address
- 40 Milliken LN
St Augustine, FL 32080-8425 - Phone
- (404) 630-3595
- Fax
- (404) 630-3595
- NPI assigned
- May 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT005235 | GA | |
| Neurology Physical Therapist | 2251N0400X | PT005235 | GA | |
| Pediatric Physical Therapist | 2251P0200X | PT005235 | GA | |
| Physical Therapist | 225100000X | PT28203 | FL | Primary |
Addresses
Primary practice location
40 Milliken LN
St Augustine, FL 32080-8425
Mailing address
40 Milliken LN
St Augustine, FL 32080-8425
Phone (404) 630-3595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000902767A | Medicaid | GA |
Other names 1
- Miss Donna Denise Browder
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 |
|---|---|---|---|
| PT28203 | FL | MD | Physical Therapist |
| PT005235 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1114978756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 MILLIKEN LN",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320808425",
"telephone_number": "404-630-3595",
"fax_number": "404-630-3595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MILLIKEN LN",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320808425",
"telephone_number": "404-630-3595",
"fax_number": "404-630-3595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "DONNA",
"middle_name": "BROWDER",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-15",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT005235",
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "GA",
"license": "PT005235",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "GA",
"license": "PT005235",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT28203",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000902767A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DONNA",
"last_name": "BROWDER",
"middle_name": "DENISE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.