Active NPI
Sarah Lynn Grace, PTA
- Physical Therapy Assistant
- Novi, MI
National Provider Identifier
1336580331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5502003609
- Practice address
- 39450 W 12 Mile Road
Suite 1a
Novi, MI 48377-0000 - Phone
- (248) 344-2300
- NPI assigned
- Jul 8, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502003609 | MI | Primary |
Addresses
Primary practice location
39450 W 12 Mile Road
Suite 1a
Novi, MI 48377-0000
Mailing address
39751 Greenview PL Apt 4
Plymouth, MI 48170-4567
Phone (734) 353-8125
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502003609 | MI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1336580331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39751 GREENVIEW PL APT 4",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704567",
"telephone_number": "734-353-8125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39450 W 12 MILE ROAD",
"address_2": "SUITE 1A",
"city": "NOVI",
"state": "MI",
"postal_code": "483770000",
"telephone_number": "248-344-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "SARAH",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-08",
"last_updated": "2024-10-25",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502003609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.