Active NPI
Grace Carter
- Physical Therapy Assistant
- Green Cove Springs, FL
National Provider Identifier
1790107449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 24646
- Practice address
- 803 Oak St
Green Cove Springs, FL 32043-4317 - Phone
- (904) 284-5606
- NPI assigned
- Jan 15, 2014
- 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 | 24646 | FL | Primary |
Addresses
Primary practice location
803 Oak St
Green Cove Springs, FL 32043-4317
Mailing address
1591 Rivers Rd
Green Cove Springs, FL 32043-9389
Phone (904) 501-1453
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24646 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389744000000",
"number": "1790107449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1591 RIVERS RD",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320439389",
"telephone_number": "904-501-1453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 OAK ST",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320434317",
"telephone_number": "904-284-5606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-15",
"last_updated": "2014-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "24646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Cove Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.