Individual provider Active NPI

Adriana Cullinan, DPT

  • Physical Therapist
  • Boone, IA
National Provider Identifier
1417654716
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
118169 Issued in IA
Practice address
1504 S Story St Ste 6
Boone, IA 50036-5224
Phone
(515) 236-9014
NPI assigned
Feb 8, 2023
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 118169 IA Primary

Addresses

Primary practice location

1504 S Story St Ste 6
Boone, IA 50036-5224

Mailing address

PO Box 461
Nevada, IA 50201-0461
Phone (515) 382-3366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230331000927 IA Practitioner - Physical Therapist in Private Practice 0042685273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
21St Century Rehab PCGroup PAC ID 1456250448, 29 clinicians

Practice addresses (Care Compare)

1504 S Story St
Suite 6
Boone, IA 50036-5224
Phone (515) 236-9014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
21St Century Rehab, PC Physical Therapist Current Accepting new patients
21St Century Rehab PC CurrentSince Feb 5, 2025 Accepting new patients
Fort Dodge Physical Therapy, LLC Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
21St Century Rehab PC PastSince Feb 5, 2025 Accepting new patients

Locations

1003 8th St SW
Ste D
Altoona, IA 50009
Phone (515) 967-4121

1504 S Story St
Ste 6
Boone, IA 50036
Phone (515) 236-9014

102 N 25th St
Fort Dodge, IA 50501
Phone (515) 416-8822

209 W 2nd St
Madrid, IA 50156
Phone (515) 795-2427

Organizations & group practices 4

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1417654716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502010461",
            "telephone_number": "515-382-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 S STORY ST STE 6",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500365224",
            "telephone_number": "515-236-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLINAN",
        "first_name": "ADRIANA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "118169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.