Individual provider Active NPI

Jennifer Ann Grattan, P.T.

  • Physical Therapist
  • Kailua, HI
National Provider Identifier
1780879288
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1829 Issued in HI
Practice address
407 Uluniu St Ste 301
Kailua, HI 96734-2544
Phone
(808) 261-4321
Fax
(808) 261-4320
NPI assigned
Sep 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT22860 CA
Physical Therapist 225100000X 1829 HI Primary

Addresses

Primary practice location

407 Uluniu St Ste 301
Kailua, HI 96734-2544

Mailing address

407 Uluniu St Ste 301
Kailua, HI 96734-2544
Phone (808) 261-4321

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

LicenseStateTypeSpecialty
PT22860CAMDPhysical Therapist
1829HIMDPhysical Therapist
22860CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Oct 26, 2021 Accepting new patients
Fukuji & Lum Physical Therapy Associates Inc. Physical Therapist PastSince Sep 9, 2005 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

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.

NPI Registry JSON

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

{
    "created_epoch": "1189296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1780879288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 301",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544",
            "telephone_number": "808-261-4321",
            "fax_number": "808-261-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 301",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544",
            "telephone_number": "808-261-4321",
            "fax_number": "808-261-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATTAN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-09",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22860",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "1829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.