Active NPI
Gina Marie Cunningham, PT, DPT
- Physical Therapist
- King of Prussia, PA
National Provider Identifier
1508106196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT022587
- Practice address
- 120 Valley Green LN Ste 610
King of Prussia, PA 19406-2080 - Phone
- (484) 685-3045
- Fax
- (484) 685-3046
- NPI assigned
- Feb 19, 2013
- 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 | PT022587 | PA | Primary |
Addresses
Primary practice location
120 Valley Green LN Ste 610
King of Prussia, PA 19406-2080
Mailing address
PO Box 22581
New York, NY 10087-2581
Phone (610) 482-4795
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103888224-0001 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gina.cunningham@axia.eclinicaldirectplus.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
120 Valley Green LN
Suite 610
King of Prussia, PA 19406-2080
Phone (484) 685-3045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT022587 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Womens Health Group LLC | Physical Therapist | Current | Accepting new patients |
| Regional Women'S Health Group, LLC | Past | Accepting new patients |
Locations
919 Conestoga Rd
Ste 104
Bryn Mawr, PA 19010
Phone (610) 525-6400
120 Valley Green Ln
Ste 610
King of Prussia, PA 19406
Phone (484) 685-3045
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Phoenixville, PA
- NPI 1750880118
Physical Therapist
-
- Obstetrics & Gynecology Physician
- Voorhees, NJ
- NPI 1548215536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1508106196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22581",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100872581",
"telephone_number": "610-482-4795",
"fax_number": "856-528-3117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 VALLEY GREEN LN STE 610",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194062080",
"telephone_number": "484-685-3045",
"fax_number": "484-685-3046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "GINA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-19",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT022587",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103888224-0001",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gina.cunningham@axia.eclinicaldirectplus.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "120 Valley Green Ln Ste 610",
"city": "King Of Prussia",
"state": "PA",
"country_code": "US",
"postal_code": "194062080",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.