Granite Bay Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27707 Issued in CA

Legal business name

GRANITE BAY PHYSICAL THERAPY

Practice address

6910 Douglas Blvd
Suite D
Granite Bay, CA 95746-6276

Phone

(916) 791-5011

Fax

(916) 791-3211

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Christopher Headrick, DPTNPI 1396844775

Title

Owner

Phone

(916) 791-5011

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Headrick, PT

  • Physical Therapist
  • Granite Bay, CA
  • NPI 1396844775
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306904594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 DOUGLAS BLVD",
            "address_2": "SUITE D",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466276",
            "telephone_number": "916-791-5011",
            "fax_number": "916-791-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 DOUGLAS BLVD",
            "address_2": "SUITE D",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466276",
            "telephone_number": "916-791-5011",
            "fax_number": "916-791-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE BAY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEADRICK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-791-5011",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Gonzalez
• Lauren Goodman
• Jon Austin Gorman, THERAPIST
• Granite Bay Countryhouse LLC
• Granite Bay Pharmacy Advisors Inc
• Granite Bay Vision Center Optometry, Inc.
• Granite Pointe Psychiatry Group, Inc.
• Julee Greeson
• Elyse Grosskopf
• Kenia Guijarro-Rangel

• Physical Therapist in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.