Individual provider Active NPI

Stephanie Marie Grieger, PT

  • Physical Therapist
  • Waverly, IA
National Provider Identifier
1477801223
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005036 Issued in IA
Practice address
1810 4TH St SW Ste 103a
Waverly, IA 50677-4389
Phone
(319) 352-1234
Fax
(319) 352-4655
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005036 IA Primary
Pediatric Physical Therapist 2251P0200X 005036 IA
Orthopedic Physical Therapist 2251X0800X 005036 IA

Addresses

Primary practice location

1810 4TH St SW Ste 103a
Waverly, IA 50677-4389

Mailing address

1810 4TH St SW Ste 103a
Waverly, IA 50677-4389
Phone (319) 352-1234

Other identifiers 1

IdentifierTypeStateIssuer
0665992MedicaidIA

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
005036IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1477801223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 4TH ST SW STE 103A",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506774389",
            "telephone_number": "319-352-1234",
            "fax_number": "319-352-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 4TH ST SW STE 103A",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506774389",
            "telephone_number": "319-352-1234",
            "fax_number": "319-352-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEGER",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "005036",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IA",
            "license": "005036",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IA",
            "license": "005036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665992",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.