Sovereign Grace Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03690 Issued in IA

Legal business name

SOVEREIGN GRACE THERAPY

Practice address

1850 Sunnyside Ave
Burlington, IA 52601-4423

Phone

(319) 601-9768

NPI assigned

Nov 8, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Sanjee Benjamin Geralde Ang, PTNPI 1467669846

Title

Founder

Phone

(319) 601-9768

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sanjee Benjamin G Ang, PT

  • Physical Therapist
  • Burlington, IA
  • NPI 1467669846
  NPD (past) Authorized official

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

{
    "created_epoch": "1415404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415404800000",
    "number": "1679979280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SUNNYSIDE AVE",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014423",
            "telephone_number": "319-601-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SUNNYSIDE AVE",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014423",
            "telephone_number": "319-601-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN GRACE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-08",
        "last_updated": "2014-11-08",
        "status": "A",
        "authorized_official_last_name": "ANG",
        "authorized_official_first_name": "SANJEE BENJAMIN",
        "authorized_official_middle_name": "GERALDE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "319-601-9768",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Riley Smith, M.F.T.
• Southeast Iowa Area Agency on Aging, Inc.
• Southeast Iowa Open MRI
• Southeast Iowa Orthopedics & Sports Medicine PC
• Southeast Iowa Regional Medical Center, Inc.
• Cinnamon L Spear, OTR/L
• Arnold A Sperfslage, D.D.S.
• Spitz Eyecare LLC
• SRR,PLLC
• Anna Nicole Stewart, RRT

• Physical Therapist in Burlington, IA
• Providers in Burlington, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.