Active NPI
Stanton W Sanderson, PT
- Physical Therapist
- Grass Valley, CA
National Provider Identifier
1740264258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT13694
- Practice address
- 10566 Brunswick Rd
#4
Grass Valley, CA 95945-9323 - Phone
- (530) 273-4152
- Fax
- (530) 273-4153
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- 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 | PT13694 | CA | Primary |
Addresses
Primary practice location
10566 Brunswick Rd
#4
Grass Valley, CA 95945-9323
Mailing address
PO Box 612260
San Jose, CA 95161-2260
Phone (877) 325-2776
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 |
|---|---|---|---|
| PT13694 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wildwood Physical Therapy Inc | Current | Accepting new patients | |
| New Edge Physical Therapy Inc | Physical Therapist | Current | Accepting new patients |
Locations
11392 Pleasant Valley Rd
Penn Valley, CA 95946
Phone (530) 432-9660
Organizations & group practices 2
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.
-
- Physical Therapist
- Penn Valley, CA
- NPI 1477196111
-
- Physical Therapy Clinic/Center
- Penn Valley, CA
- NPI 1952300782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1740264258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 612260",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951612260",
"telephone_number": "877-325-2776",
"fax_number": "408-945-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10566 BRUNSWICK RD",
"address_2": "#4",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459323",
"telephone_number": "530-273-4152",
"fax_number": "530-273-4153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERSON",
"first_name": "STANTON",
"middle_name": "W",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT13694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.