Individual provider Active NPI

Sydney Hope Sallach Grams, PT, DPT

  • Physical Therapist
  • St Augustine, FL
National Provider Identifier
1730967407
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
105 Southpark Blvd Ste B201
St Augustine, FL 32086-5159
Phone
(904) 824-1636
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

105 Southpark Blvd Ste B201
St Augustine, FL 32086-5159

Mailing address

285 San Marco St
St Augustine, FL 32084-5705
Phone (712) 789-2455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617001613 FL Practitioner - Physical Therapist in Private Practice 7416490636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Rehabilitation Services of Florida LLC Physical Therapist Current Accepting new patients
Burke Collins Therapy, Inc CurrentSince May 1, 2024 Accepting new patients
H2 Rehabilitation Services of Florida LLC CurrentSince May 1, 2024 Accepting new patients

Locations

831 Santa Barbara Blvd
Ste 227
Cape Coral, FL 33991

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1730967407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SAN MARCO ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845705",
            "telephone_number": "712-789-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD STE B201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865159",
            "telephone_number": "904-824-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMS",
        "first_name": "SYDNEY",
        "middle_name": "HOPE SALLACH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.