Individual provider Active NPI

Sara Mraz

  • Physical Therapist
  • Brunswick, GA
National Provider Identifier
1750511614
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009597 Issued in GA
Practice address
2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone
(912) 466-7000
NPI assigned
Jul 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009597 GA Primary
Physical Therapist 225100000X 7716 AZ
Physical Therapist 225100000X 60002785 WA
Physical Therapist 225100000X 22806 MD
Physical Therapist 225100000X 2705 NE

Addresses

Primary practice location

2415 Parkwood Dr
Brunswick, GA 31520-4722

Mailing address

2415 Parkwood Dr
Brunswick, GA 31520-4722

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

State licenses

LicenseStateTypeSpecialty
22806MDMDSocial Worker
7716AZMDPhysical Therapist
PT009597GAMDPhysical Therapist
60002785WAMDPhysical Therapist
2705NEMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1750511614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204722",
            "telephone_number": "912-466-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRAZ",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009597",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7716",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60002785",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22806",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.