Active NPI
Judith Ann Grandinetti, LPTA
- Specialist
- Centreville, VA
National Provider Identifier
1376782839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PTA 21540
- Practice address
- 6007 Creekstone LN
Centreville, VA 20120-3408 - Phone
- (703) 628-9507
- NPI assigned
- Feb 6, 2009
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PTA 21540 | FL | Primary |
Addresses
Primary practice location
6007 Creekstone LN
Centreville, VA 20120-3408
Mailing address
6007 Creekstone LN
Centreville, VA 20120-3408
Phone (703) 628-9507
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 |
|---|---|---|---|
| PTA 21540 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233878400000",
"number": "1376782839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6007 CREEKSTONE LN",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201203408",
"telephone_number": "703-628-9507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6007 CREEKSTONE LN",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201203408",
"telephone_number": "703-628-9507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDINETTI",
"first_name": "JUDITH",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "LPTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-06",
"last_updated": "2009-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "PTA 21540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.