Active NPI
Dawn Grottke, A.T.,C, P.T.A.
- Physical Therapy Assistant
- Carlsbad, CA
National Provider Identifier
1457464216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT4207
- Practice address
- 5814 Van Allen Way Ste 210
Carlsbad, CA 92008-7360 - Phone
- (760) 438-4466
- Fax
- (760) 431-7218
- NPI assigned
- Aug 16, 2006
- 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 | AT4207 | CA | Primary |
Addresses
Primary practice location
5814 Van Allen Way Ste 210
Carlsbad, CA 92008-7360
Mailing address
1145 S Clementine St
Oceanside, CA 92054-5235
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 |
|---|---|---|---|
| AT4207 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457464216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 S CLEMENTINE ST",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920545235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5814 VAN ALLEN WAY STE 210",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920087360",
"telephone_number": "760-438-4466",
"fax_number": "760-431-7218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROTTKE",
"first_name": "DAWN",
"credential": "A.T.,C, P.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT4207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.