Individual provider Active NPI

Cyndee L Harrison, PT

  • Physical Therapist
  • Southlake, TX
National Provider Identifier
1396965323
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1043453TX Issued in TX
Practice address
190 S Peytonville Ave
Ste 100
Southlake, TX 76092-6937
Phone
(817) 329-5333
Fax
(817) 268-2802
NPI assigned
May 1, 2007
Last updated
Oct 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 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 1043453TX TX Primary

Addresses

Primary practice location

190 S Peytonville Ave
Ste 100
Southlake, TX 76092-6937

Mailing address

190 S Peytonville Ave
Ste 100
Southlake, TX 76092-6937
Phone (817) 329-5333

Other identifiers 2

IdentifierTypeStateIssuer
1043453TXOtherTXSTATE LICENSE NUMBER
8T6952OtherTXBLUE CROSS BLUE SHIELD

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
1043453TXTXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1396965323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 S PEYTONVILLE AVE",
            "address_2": "STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926937",
            "telephone_number": "817-329-5333",
            "fax_number": "817-268-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S PEYTONVILLE AVE",
            "address_2": "STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926937",
            "telephone_number": "817-329-5333",
            "fax_number": "817-268-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "CYNDEE",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1043453TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1043453TX",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8T6952",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.