Ivy Morgan Grenier, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1428 Issued in NH

Practice address

169 Main St Apt 3a
Charlestown, NH 03603-4925

Phone

(603) 558-2638

NPI assigned

Feb 20, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ivy Simoneau Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1174388904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291",
            "city": "CHARLESTOWN",
            "state": "NH",
            "postal_code": "036030291",
            "telephone_number": "603-558-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MAIN ST APT 3A",
            "city": "CHARLESTOWN",
            "state": "NH",
            "postal_code": "036034925",
            "telephone_number": "603-558-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENIER",
        "first_name": "IVY",
        "middle_name": "MORGAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "1428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVY",
            "last_name": "SIMONEAU",
            "credential": "PTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tamara Lee Golden, HNB-BC, WHE, NBC-HWC
• Clare Barrett Gowen, PT
• Amelia Merchant Grabe, D.M.D.
• George H. Grabe, D.M.D.
• Debra Lee Gray, COTA/L
• Brendan A. Klema, DC
• Terrell G Klema, DC
• Michelle Frances Lackovic, M.D.
• Ashley McNamara, ATC
• Carol McShane, RN, MSN

• Physical Therapy Assistant in Charlestown, NH
• Providers in Charlestown, NH by specialty
• Physical Therapy Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.