Individual provider Active NPI

Nejama R Granada, PT

  • Physical Therapist
  • Towson, MD
National Provider Identifier
1194846840
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19135 Issued in MD
Practice address
1220A E Joppa Rd Ste 234
Towson, MD 21286-5817
Phone
(410) 337-2470
Fax
(410) 337-2471
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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 19135 MD Primary

Addresses

Primary practice location

1220A E Joppa Rd Ste 234
Towson, MD 21286-5817

Mailing address

6914 Holabird Ave
Baltimore, MD 21222-1747
Phone (410) 284-5441

Other practice location 1

515 Brightfield Rd
Lutherville, MD 21093-3643
Phone (410) 296-1990 ext. 398

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
19135MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Fitness Physical Therapy LLC Physical Therapist Past 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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1194846840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6914 HOLABIRD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212221747",
            "telephone_number": "410-284-5441",
            "fax_number": "410-284-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220A E JOPPA RD STE 234",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865817",
            "telephone_number": "410-337-2470",
            "fax_number": "410-337-2471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Brightfield Rd",
            "address_purpose": "LOCATION",
            "city": "Lutherville",
            "state": "MD",
            "postal_code": "210933643",
            "country_code": "US",
            "telephone_number": "410-296-1990 x398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANADA",
        "first_name": "NEJAMA",
        "middle_name": "R",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.