Individual provider Active NPI

Brenda Lee Grimaldi, PT

  • Physical Therapist
  • Bradenton, FL
National Provider Identifier
1386767044
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 4578 Issued in FL
Practice address
6015 Pointe West Blvd
Bradenton, FL 34209-5525
Phone
(941) 792-1404
NPI assigned
Apr 9, 2007
Last updated
Jul 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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 PT 4578 FL Primary

Addresses

Primary practice location

6015 Pointe West Blvd
Bradenton, FL 34209-5525

Mailing address

710 134TH St E
Bradenton, FL 34212-9492
Phone (941) 746-0243

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
PT 4578FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine of Southwest FL, PA PastSince Jul 1, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1386767044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 134TH ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342129492",
            "telephone_number": "941-746-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095525",
            "telephone_number": "941-792-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDI",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 4578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.