Individual provider Active NPI

Rose Willow Cunningham, PT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1396065074
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1014 Issued in NM
Practice address
6330 Riverside Plaza LN NW
Suite 150
Albuquerque, NM 87120-2681
Phone
(505) 312-7930
Fax
(505) 717-2818
NPI assigned
Jun 4, 2010
Last updated
May 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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 1014 NM Primary

Addresses

Primary practice location

6330 Riverside Plaza LN NW
Suite 150
Albuquerque, NM 87120-2681

Mailing address

600 Central Ave SE
Suite D
Albuquerque, NM 87102-3656
Phone (505) 242-2294

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

LicenseStateTypeSpecialty
1014NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy at Dawn Inc PastSince May 1, 2013 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1396065074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CENTRAL AVE SE",
            "address_2": "SUITE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023656",
            "telephone_number": "505-242-2294",
            "fax_number": "505-242-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 RIVERSIDE PLAZA LN NW",
            "address_2": "SUITE 150",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202681",
            "telephone_number": "505-312-7930",
            "fax_number": "505-717-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "ROSE",
        "middle_name": "WILLOW",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.