Active NPI
Kelsey Grimaldi, PT
- Physical Therapist
- Merced, CA
National Provider Identifier
1174077218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 303067
- Practice address
- 333 Mercy Ave
Merced, CA 95340-8319 - Phone
- (209) 564-5000
- NPI assigned
- Aug 5, 2016
- 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 | 303067 | CA | Primary |
Addresses
Primary practice location
333 Mercy Ave
Merced, CA 95340-8319
Mailing address
710 134TH St E
Bradenton, FL 34212-9492
Phone (941) 524-0396
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303067 | Other | CA | CALIFORNIA BOARD OF PHYSICAL THERAPY |
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 |
|---|---|---|---|
| 303067 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1174077218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 134TH ST E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342129492",
"telephone_number": "941-524-0396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 MERCY AVE",
"city": "MERCED",
"state": "CA",
"postal_code": "953408319",
"telephone_number": "209-564-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMALDI",
"first_name": "KELSEY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-05",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "303067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF PHYSICAL THERAPY",
"identifier": "303067",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.