Active NPI
Grace Marie Hanna, DPT
- Physical Therapist
- Gold Canyon, AZ
National Provider Identifier
1144833864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6996
- Practice address
- 6804 S Kings Ranch Rd Ste 103
Gold Canyon, AZ 85118-2960 - Phone
- (480) 983-8600
- NPI assigned
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6996 | ID | Primary |
Addresses
Primary practice location
6804 S Kings Ranch Rd Ste 103
Gold Canyon, AZ 85118-2960
Mailing address
6804 S Kings Ranch Rd Ste 103
Gold Canyon, AZ 85118-2960
Phone (864) 350-9688
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6996 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1144833864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6804 S KINGS RANCH RD STE 103",
"city": "GOLD CANYON",
"state": "AZ",
"postal_code": "851182960",
"telephone_number": "864-350-9688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6804 S KINGS RANCH RD STE 103",
"city": "GOLD CANYON",
"state": "AZ",
"postal_code": "851182960",
"telephone_number": "480-983-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNA",
"first_name": "GRACE",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-24",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "6996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gold Canyon, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.