Individual provider Active NPI

Deborah Granberg, MSPT

  • Physical Therapist
  • Broomfield, CO
National Provider Identifier
1194549543
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4741 Issued in CO
Practice address
17351 Drake St
Broomfield, CO 80023-5205
Phone
(303) 908-0500
Fax
(720) 465-9320
NPI assigned
Nov 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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 4741 CO Primary

Addresses

Primary practice location

17351 Drake St
Broomfield, CO 80023-5205

Mailing address

14786 Grape St
Thornton, CO 80602-8565
Phone (720) 323-9238

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

LicenseStateTypeSpecialty
4741COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kind Rehabilitation LLC Physical Therapist CurrentSince Nov 13, 2024 Accepting new patients

Organizations & group practices 1

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": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1194549543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14786 GRAPE ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806028565",
            "telephone_number": "720-323-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17351 DRAKE ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800235205",
            "telephone_number": "303-908-0500",
            "fax_number": "720-465-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANBERG",
        "first_name": "DEBORAH",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "4741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.