Active NPI
Taylor Grove, PTA, BS, CPT, CEP
- Physical Therapy Assistant
- Indianapolis, IN
National Provider Identifier
1750100962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06006868A
- Practice address
- 5515 W 38TH St
Indianapolis, IN 46254-2995 - Phone
- (317) 880-0280
- Fax
- (317) 880-0296
- NPI assigned
- Oct 4, 2024
- Sex
- Female
- 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 Therapy Assistant | 225200000X | 06006868A | IN | Primary |
Addresses
Primary practice location
5515 W 38TH St
Indianapolis, IN 46254-2995
Mailing address
115 Conradt Ave
Kokomo, IN 46901-5253
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06006868A | IN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1750100962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 CONRADT AVE",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469015253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5515 W 38TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462542995",
"telephone_number": "317-880-0280",
"fax_number": "317-880-0296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVE",
"first_name": "TAYLOR",
"credential": "PTA, BS, CPT, CEP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-04",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06006868A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.