Individual provider Active NPI

Julie Grant, OTR

  • Specialist
  • Daphne, AL
National Provider Identifier
1669677712
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1917 Issued in AL
Practice address
790A Daphne Ave
Daphne, AL 36526-4657
Phone
(251) 408-9287
Fax
(800) 721-2101
NPI assigned
Jun 19, 2007
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1917 AL Primary

Addresses

Primary practice location

790A Daphne Ave
Daphne, AL 36526-4657

Mailing address

314 Whiting CT
Daphne, AL 36526-4616
Phone (251) 408-9287

Other practice location 1

5767 Airport Blvd
Ste. B
Mobile, AL 36608-3101
Phone (251) 344-4212

Other practice location 2

1745 Main St Ste D
Daphne, AL 36526
Phone (251) 408-9287

Other identifiers 3

IdentifierTypeStateIssuer
515-45356OtherALBCBS DAPHNE LOCATION
L223OtherALMEDICARE GROUP
51542827OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000174 AL Practitioner - Occupational Therapist in Private Practice 4284729971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edema Therapy CompanyGroup PAC ID 1759507940, 5 clinicians

Practice addresses (Care Compare)

27495 U S Hwy 98
Daphne, AL 36526
Phone (251) 408-9287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1917ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edema Therapy Company CurrentSince Jul 24, 2014 Accepting new patients
Edema Therapy Company CurrentSince Apr 30, 2014 Accepting new patients
Cancer Rehab & Edema Specialist Specialist PastSince Apr 1, 2021 Accepting new patients

Locations

1745 Main St
Ste D
Daphne, AL 36526
Phone (251) 408-9287

27495 US Highway 98
Daphne, AL 36526
Phone (251) 408-9287

790A Daphne Ave
Daphne, AL 36526
Phone (251) 408-9287

12456 Sandy Ln
Foley, AL 36535
Phone (251) 533-4651

Organizations & group practices 3

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1669677712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 WHITING CT",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264616",
            "telephone_number": "251-408-9287",
            "fax_number": "800-721-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790A DAPHNE AVE",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264657",
            "telephone_number": "251-408-9287",
            "fax_number": "800-721-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5767 Airport Blvd",
            "address_2": "STE. B",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366083101",
            "country_code": "US",
            "telephone_number": "251-344-4212",
            "fax_number": "251-344-4302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1745 Main St Ste D",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "36526",
            "country_code": "US",
            "telephone_number": "251-408-9287",
            "fax_number": "800-721-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JULIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "1917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DAPHNE LOCATION",
            "identifier": "515-45356",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "L223",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51542827",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.