Individual provider Active NPI

Christina Granquist, D.P.T.

  • Physical Therapist
  • West Orange, NJ
National Provider Identifier
1326449216
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01571700 Issued in NJ
Practice address
622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone
(973) 669-0078
NPI assigned
Sep 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01571700 NJ Primary

Addresses

Primary practice location

622 Eagle Rock Ave
West Orange, NJ 07052-2994

Mailing address

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078

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

LicenseStateTypeSpecialty
40QA01571700NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1326449216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-669-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-669-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANQUIST",
        "first_name": "CHRISTINA",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01571700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.