Active NPI
Corey Mathew Cundall
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1205614831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2202
- Practice address
- 6404 N 70TH PLZ
Omaha, NE 68104-1074 - Phone
- (531) 210-5700
- NPI assigned
- Sep 15, 2023
- Last updated
- Sep 15, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2202 | NE | Primary |
Addresses
Primary practice location
6404 N 70TH PLZ
Omaha, NE 68104-1074
Mailing address
6404 N 70TH PLZ
Omaha, NE 68104-1074
Phone (531) 210-5700
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202 | NE | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1205614831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6404 N 70TH PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681041074",
"telephone_number": "531-210-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6404 N 70TH PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681041074",
"telephone_number": "531-210-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNDALL",
"first_name": "COREY",
"middle_name": "MATHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-15",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2202",
"primary": true
}
],
"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 Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.