Active NPI
Christopher J Grande, PHYSICAL THERAPIST
- Physical Therapist
- West Palm Beach, FL
National Provider Identifier
1386678258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-23760
- Practice address
- 1896 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-3513 - Phone
- (561) 432-0111
- Fax
- (561) 432-1075
- NPI assigned
- Jul 10, 2006
- 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 | PT-23760 | FL | Primary |
Addresses
Primary practice location
1896 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-3513
Mailing address
110 Waterview Dr
Palm Beach Gardens, FL 33418-7103
Phone (856) 649-4701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-23760 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolution Rehab Group LLC | Physical Therapist | Current | Accepting new patients |
| Bay-Sea Physical Therapy of Bridgeton PA | Physical Therapist | Past | Accepting new patients |
| Bay-Sea Physical Therapy of Vineland PA | Physical Therapist | Past | Accepting new patients |
Locations
7950 Dani Dr
#1402
Fort Myers, FL 33966
Phone (561) 900-2423
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Jupiter, FL
- NPI 1023840246
-
- Physical Therapist
- Bridgeton, NJ
- NPI 1568468072
-
- Physical Therapist
- Vineland, NJ
- NPI 1548266042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1386678258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WATERVIEW DR",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334187103",
"telephone_number": "856-649-4701",
"fax_number": "561-432-1075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1896 PALM BEACH LAKES BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334093513",
"telephone_number": "561-432-0111",
"fax_number": "561-432-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDE",
"first_name": "CHRISTOPHER",
"middle_name": "J",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT-23760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.