Individual provider Active NPI

Ronald Lee Cunningham, MPT

  • Physical Therapist
  • Fullerton, CA
National Provider Identifier
1124115407
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12080 Issued in CA
Practice address
680 Langsdorf Dr
Suite 100
Fullerton, CA 92831-3702
Phone
(714) 871-0460
Fax
(714) 871-5342
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 PT12080 CA Primary

Addresses

Primary practice location

680 Langsdorf Dr
Suite 100
Fullerton, CA 92831-3702

Mailing address

680 Langsdorf Dr
Suite 100
Fullerton, CA 92831-3702
Phone (909) 606-9553

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001763 CA Practitioner - Physical Therapist in Private Practice 0042208308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fullerton Physical Therapy and Sports Care, IncGroup PAC ID 9638166572, 2 clinicians

Practice addresses (Care Compare)

680 Langsdorf Dr
Suite 100
Fullerton, CA 92831-3702
Phone (714) 871-0460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT12080CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fullerton Physical Therapy & Sports Care, Inc. CurrentSince Apr 30, 2004 Accepting new patients

Locations

680 Langsdorf Dr
Ste 100
Fullerton, CA 92831
Phone (714) 871-0460

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1124115407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR",
            "address_2": "SUITE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313702",
            "telephone_number": "909-606-9553",
            "fax_number": "714-871-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR",
            "address_2": "SUITE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313702",
            "telephone_number": "714-871-0460",
            "fax_number": "714-871-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "RONALD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.