Individual provider Active NPI

Lauren Renee Greulich, B. A.

  • Physical Therapy Assistant
  • Columbia City, IN
National Provider Identifier
1952736787
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06004677A Issued in IN
Practice address
169 N 200 E
Columbia City, IN 46725-8895
Phone
(260) 244-5133
NPI assigned
Sep 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06004677A IN Primary

Addresses

Primary practice location

169 N 200 E
Columbia City, IN 46725-8895

Mailing address

169 N 200 E
Columbia City, IN 46725-8895
Phone (260) 244-5133

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
06004677AINMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Orthopedic & Sports Physical Therapy, P.C. PastSince Jan 1, 2006 Accepting new patients

Organizations & group practices 1

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": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1952736787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 N 200 E",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467258895",
            "telephone_number": "260-244-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N 200 E",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467258895",
            "telephone_number": "260-244-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREULICH",
        "first_name": "LAUREN",
        "middle_name": "RENEE",
        "credential": "B. A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06004677A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.