Active NPI
Geordie Vincent Griener, MPT
- Physical Therapist
- St Augustine, FL
National Provider Identifier
1376681247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT19163
- Practice address
- 1 Orthopaedic PL
St Augustine, FL 32086-4202 - Phone
- (904) 825-0540
- Fax
- (904) 217-8057
- NPI assigned
- Feb 2, 2007
- Sex
- Male
- 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 Therapist | 225100000X | PT19163 | FL | Primary |
Addresses
Primary practice location
1 Orthopaedic PL
St Augustine, FL 32086-4202
Mailing address
382 Travino Ave
St Augustine, FL 32086-7369
Phone (904) 797-7310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890192900 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387238400000",
"number": "1376681247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "382 TRAVINO AVE",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320867369",
"telephone_number": "904-797-7310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ORTHOPAEDIC PL",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320864202",
"telephone_number": "904-825-0540",
"fax_number": "904-217-8057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIENER",
"first_name": "GEORDIE",
"middle_name": "VINCENT",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2013-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT19163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890192900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.