Individual provider Active NPI

Scott Cunningham, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1003941469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1672 Issued in NE
Practice address
3624 N. 163Rd Plaza
Omaha, NE 68116
Phone
(402) 505-9611
Fax
(402) 505-4683
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1672 NE Primary
Physical Therapist 225100000X 3499 IA

Addresses

Primary practice location

3624 N. 163Rd Plaza
Omaha, NE 68116

Mailing address

3624 N. 163Rd Plaza
Omaha, NE 68116
Phone (402) 505-9611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822001228 NE Practitioner - Physical Therapist in Private Practice 2062504087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Father Flanagans Boys HomeGroup PAC ID 9638165400, 93 clinicians

Practice addresses (Care Compare)

555 N 30TH St
Boys Town National Research Hospital Downto
Omaha, NE 68131-2136
Phone (531) 355-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1672NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home CurrentSince Mar 21, 2020 Accepting new patients
Father Flanagan'S Boys Home Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003941469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 N. 163RD PLAZA",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68116",
            "telephone_number": "402-505-9611",
            "fax_number": "402-505-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 N. 163RD PLAZA",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68116",
            "telephone_number": "402-505-9611",
            "fax_number": "402-505-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SCOTT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1672",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "3499",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.