Individual provider Active NPI

Princetta Cyntrelle Cummings

  • Physical Therapy Assistant
  • Fort Worth, TX
National Provider Identifier
1093432981
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2172836 Issued in TX
Practice address
1000 Saint Louis Ave Ste 102
Ft Worth, TX 76104-3377
Phone
(469) 291-8500
NPI assigned
Oct 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 2172836 TX Primary

Addresses

Primary practice location

1000 Saint Louis Ave Ste 102
Ft Worth, TX 76104-3377

Mailing address

5220 Spring Valley Rd Ste 400
Dallas, TX 75254-2512
Phone (214) 466-1340

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

LicenseStateTypeSpecialty
2172836TXMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1093432981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 SPRING VALLEY RD STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542512",
            "telephone_number": "214-466-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SAINT LOUIS AVE STE 102",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761043377",
            "telephone_number": "469-291-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "PRINCETTA",
        "middle_name": "CYNTRELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2172836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.