Active NPI
Laura Degrange
- Physical Therapist
- Providence, RI
National Provider Identifier
1942430475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT02898
- Practice address
- 1000 Eddy St
Providence, RI 02905-4739 - Phone
- (401) 533-9100
- NPI assigned
- Jul 17, 2009
- 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 Therapist | 225100000X | PT02898 | RI | Primary |
Addresses
Primary practice location
1000 Eddy St
Providence, RI 02905-4739
Mailing address
1000 Eddy St
Providence, RI 02905-4739
Phone (401) 533-9100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0614 | Other | RI | NEIGHBORHOOD HEALTH PLAN |
| SB870 | Other | RI | BLUE CROSS |
| ES01788 | Medicaid | RI |
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 |
|---|---|---|---|
| PT02898 | RI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460073600000",
"number": "1942430475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054739",
"telephone_number": "401-533-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054739",
"telephone_number": "401-533-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRANGE",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-17",
"last_updated": "2016-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "RI",
"license": "PT02898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0614",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "SB870",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ES01788",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.