Active NPI
Bobby Gragston, DPT
- Physical Therapist
- Little Rock, AR
National Provider Identifier
1245609551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4051
- Practice address
- 10014 North Rodney Parham
Suite 103
Little Rock, AR 72227 - Phone
- (501) 224-5454
- Fax
- (501) 224-5460
- NPI assigned
- Sep 16, 2015
- Last updated
- Sep 16, 2015
- Sex
- Male
- 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 | PT4051 | AR | Primary |
Addresses
Primary practice location
10014 North Rodney Parham
Suite 103
Little Rock, AR 72227
Mailing address
2251 Bill Foster Memorial Highway West
Suite B
Cabot, AR 72023
Phone (501) 941-3320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT4051 | Other | AR | PT LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1245609551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 BILL FOSTER MEMORIAL HIGHWAY WEST",
"address_2": "SUITE B",
"city": "CABOT",
"state": "AR",
"postal_code": "72023",
"telephone_number": "501-941-3320",
"fax_number": "501-224-5460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10014 NORTH RODNEY PARHAM",
"address_2": "SUITE 103",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72227",
"telephone_number": "501-224-5454",
"fax_number": "501-224-5460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAGSTON",
"first_name": "BOBBY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-16",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT4051",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "PT4051",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.