Individual provider Active NPI

Kaitlyn Grube

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1861297491
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017598 Issued in GA
Practice address
3405 Dallas Hwy SW Ste 601
Marietta, GA 30064-6427
Phone
(770) 438-5226
NPI assigned
Feb 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017598 GA Primary

Addresses

Primary practice location

3405 Dallas Hwy SW Ste 601
Marietta, GA 30064-6427

Mailing address

1875 Maple Dr Apt 408
Kennesaw, GA 30144-1677
Phone (336) 707-2251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250819001435 FL Practitioner - Physical Therapist in Private Practice 2062911860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fitness Quest - Venice LLCGroup PAC ID 9739125964, 44 clinicians

Practice addresses (Care Compare)

1401 8TH Ave W
Suite a
Palmetto, FL 34221-3171
Phone (941) 722-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017598GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Quest - Venice LLC Physical Therapist CurrentSince Aug 4, 2025 Accepting new patients
Fitness Quest - Venice LLC CurrentSince Aug 4, 2025 Accepting new patients

Locations

3657 Cortez Rd W
Ste 110
Bradenton, FL 34210
Phone (941) 361-9020

1401 8th Ave W
Ste A
Palmetto, FL 34221
Phone (941) 722-4000

400 Tamiami Trl S
Ste 210
Venice, FL 34285
Phone (877) 469-3778

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

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": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1861297491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 MAPLE DR APT 408",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441677",
            "telephone_number": "336-707-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 DALLAS HWY SW STE 601",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646427",
            "telephone_number": "770-438-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.