Active NPI
Jessica N Grande, PT, DPT, CSCS
- Physical Therapist
- Ocoee, FL
National Provider Identifier
1295931376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25095
- Practice address
- 578 Ocoee Commerce Pkwy
Ocoee, FL 34761-4219 - Phone
- (407) 656-6639
- Fax
- (407) 656-0921
- NPI assigned
- Jun 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | PT25095 | FL | Primary |
Addresses
Primary practice location
578 Ocoee Commerce Pkwy
Ocoee, FL 34761-4219
Mailing address
16849 Cedar Run Dr
Orlando, FL 32828-6977
Phone (724) 991-4718
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 |
|---|---|---|---|
| PT25095 | FL | MD | Physical Therapist |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422316800000",
"number": "1295931376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16849 CEDAR RUN DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328286977",
"telephone_number": "724-991-4718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "578 OCOEE COMMERCE PKWY",
"city": "OCOEE",
"state": "FL",
"postal_code": "347614219",
"telephone_number": "407-656-6639",
"fax_number": "407-656-0921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDE",
"first_name": "JESSICA",
"middle_name": "N",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-25",
"last_updated": "2015-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT25095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocoee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.