Individual provider Active NPI

Anthony Brian Granger, P.T.

  • Physical Therapist
  • Bakersfield, CA
National Provider Identifier
1255530697
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4382 Issued in AZ
Practice address
7737 Meany Ave Ste B5
Bakersfield, CA 93308-5267
Phone
(661) 377-1700
Fax
(661) 616-9199
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 4382 AZ
Physical Therapist 225100000X 4382 AZ Primary

Addresses

Primary practice location

7737 Meany Ave Ste B5
Bakersfield, CA 93308-5267

Mailing address

3400 Calloway Dr Ste 603
Bakersfield, CA 93312-2514
Phone (661) 377-1700

Other identifiers 1

IdentifierTypeStateIssuer
449042MedicaidAZ

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

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Physical Therapy Aquatics and Rehab Specialists Physical Therapist Past Accepting new patients
Bakersfield Memorial Hospital PastSince May 17, 2021 Accepting new patients

Organizations & group practices 2

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1255530697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR STE 603",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122514",
            "telephone_number": "661-377-1700",
            "fax_number": "661-616-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 MEANY AVE STE B5",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933085267",
            "telephone_number": "661-377-1700",
            "fax_number": "661-616-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "ANTHONY",
        "middle_name": "BRIAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "4382",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "4382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "449042",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.