Individual provider Active NPI

Sadie Grothaus

  • Physical Therapist
  • Port Orange, FL
National Provider Identifier
1467968768
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016992 Issued in OH
Practice address
5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321
Phone
(888) 265-2680
NPI assigned
Dec 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 007116 KY
Physical Therapist 225100000X PT016992 OH Primary

Addresses

Primary practice location

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321

Mailing address

210 Glazier Ave
Bellevue, KY 41073-1720

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
007116KYMDPhysical Therapist
PT016992OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Touch at Home NJ LLC Physical Therapist Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1467968768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GLAZIER AVE",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288321",
            "telephone_number": "888-265-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTHAUS",
        "first_name": "SADIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007116",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.