Sterling Granger, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4376 Issued in AR

Practice address

23 Parkcliff Dr
Holiday Island, AR 72631-9230

Phone

(479) 363-6422

Fax

(479) 363-6763

NPI assigned

Jan 13, 2020

Sex

Male

Sole proprietor

No

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.

• Wolf Wellness Center, PLLC

  • Rehabilitation Clinic/Center
  • Holiday Island, AR
  • NPI 1588037196
  NPD
• Spine and Sports Therapy LLC

  • Physical Therapist
  • Lowell, AR
  • NPI 1730454935
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 13, 2020.

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1215577754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PARKCLIFF DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319230",
            "telephone_number": "479-363-6422",
            "fax_number": "479-363-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 PARKCLIFF DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319230",
            "telephone_number": "479-363-6422",
            "fax_number": "479-363-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "STERLING",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE BOARD OF PHYSICAL THERAPY",
            "identifier": "PTA4376",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eureka Springs Hospital
• Eureka Springs Hospital
• Freds Stores of Tennessee Inc
• Carolyn S Gentry, RN
• Brooke Aubrey Granger, COTA
• Green Acre Lodge Inc.
• Jharry Ann Santos Gumabon, COTA/L
• Daxton Harris
• Jamie Holden, PTA
• Holiday Island Operations, LLC

• All providers in Holiday Island, AR
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.

Verify at the official NPI Registry.