Active NPI
Carrie Grise
- Physical Therapist
- Las Vegas, NV
National Provider Identifier
1295845170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4505
- Practice address
- 4980 W Sahara Ave Ste 260
Las Vegas, NV 89146-3435 - Phone
- (702) 216-7365
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 4505 | NV | Primary |
Addresses
Primary practice location
4980 W Sahara Ave Ste 260
Las Vegas, NV 89146-3435
Mailing address
10321 Pompei PL
Las Vegas, NV 89144-1209
Phone (952) 239-5250
Other practice location 1
4940 Viking Dr
Suite 204
Edina, MN 55435-5300
Phone (952) 897-0607
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4505 | Other | NV | PT LICENSE |
| 7554 | Other | MN | LICENSE # |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | grisec@dignityhealth.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4505 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1295845170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10321 POMPEI PL",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891441209",
"telephone_number": "952-239-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4980 W SAHARA AVE STE 260",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891463435",
"telephone_number": "702-216-7365"
}
],
"practiceLocations": [
{
"address_1": "4940 Viking Dr",
"address_2": "Suite 204",
"address_purpose": "LOCATION",
"city": "Edina",
"state": "MN",
"postal_code": "554355300",
"country_code": "US",
"telephone_number": "952-897-0607",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRISE",
"first_name": "CARRIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2021-11-08",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "4505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "4505",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "7554",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "grisec@dignityhealth.com",
"affiliation": "N",
"endpointDescription": "business email",
"address_1": "4980 W Sahara Ave Ste 206",
"city": "Las Vegas",
"state": "NV",
"country_code": "US",
"postal_code": "891463435",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.