Myranda L Griebel, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1403028 Issued in KS

Practice address

3730 N Ridge Rd
Ste 500
Wichita, KS 67205-1227

Phone

(316) 440-4901

Fax

(316) 440-4904

NPI assigned

May 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Myranda Axtell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1619323938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 1040",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023017",
            "telephone_number": "316-263-0003",
            "fax_number": "316-263-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 N RIDGE RD",
            "address_2": "STE 500",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051227",
            "telephone_number": "316-440-4901",
            "fax_number": "316-440-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEBEL",
        "first_name": "MYRANDA",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "1403028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRANDA",
            "last_name": "AXTELL",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grene Vision Group LLC
• Grene Vision Group LLC
• Grene Vision Group LLC
• Ryan Grenier, DC
• Marjorie J Gress, RD, LD
• Tara Marie Griekspoor
• Audrey Eileen Griffin, PA (PHYSICIAN ASSIST
• Toya M. C. Griffin
• John Austin William Griffith, DDS
• Rachael Jane Grill

• Physical Therapy Assistant in Wichita, KS
• Providers in Wichita, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.