Active NPI
Ginger Leigh Funk, PT
- Physical Therapist
- Herrin, IL
National Provider Identifier
1174509343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070008962
- Practice address
- 100 S Park Ave
Herrin, IL 62948-3610 - Phone
- (618) 942-3088
- Fax
- (618) 942-7116
- NPI assigned
- Dec 20, 2005
- Last updated
- Apr 2, 2024
- 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 | 070008962 | IL | Primary |
Addresses
Primary practice location
100 S Park Ave
Herrin, IL 62948-3610
Mailing address
619 S Glenview Dr
Carbondale, IL 62901-2245
Phone (618) 922-2525
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070008962 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1174509343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 S GLENVIEW DR",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629012245",
"telephone_number": "618-922-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S PARK AVE",
"city": "HERRIN",
"state": "IL",
"postal_code": "629483610",
"telephone_number": "618-942-3088",
"fax_number": "618-942-7116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNK",
"first_name": "GINGER",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-20",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070008962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.