Active NPI
Stephanie L Gradone, DPT
- Physical Therapist
- Portland, ME
National Provider Identifier
1578660478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4340
- Practice address
- 33 Sewall St
Portland, ME 04102-2603 - Phone
- (207) 828-2100
- NPI assigned
- Sep 20, 2006
- Last updated
- Nov 9, 2015
- 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 Therapist | 225100000X | PT4340 | ME | Primary |
Addresses
Primary practice location
33 Sewall St
Portland, ME 04102-2603
Mailing address
324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7800
Other names 1
- Stephanie L Gray
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT4340 | ME | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back on Track, P.C. | 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, 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": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447027200000",
"number": "1578660478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 GANNETT DR STE 200",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041063266",
"telephone_number": "207-482-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 SEWALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022603",
"telephone_number": "207-828-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADONE",
"first_name": "STEPHANIE",
"middle_name": "L",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2015-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT4340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "GRAY",
"middle_name": "L",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.