Individual provider Active NPI

Sandra Graunke

  • Physical Therapy Assistant
  • Charlotte, NC
National Provider Identifier
1477941292
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5399 Issued in NC
Practice address
3800 Shamrock Dr
Charlotte, NC 28215-3220
Phone
(704) 532-7267
NPI assigned
Dec 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5399 NC Primary

Addresses

Primary practice location

3800 Shamrock Dr
Charlotte, NC 28215-3220

Mailing address

5522 Chalyce LN
Charlotte, NC 28270-1744
Phone (704) 779-7858

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

LicenseStateTypeSpecialty
5399NCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1477941292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 CHALYCE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701744",
            "telephone_number": "704-779-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SHAMROCK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153220",
            "telephone_number": "704-532-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUNKE",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "5399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.