Active NPI
Cynthia Mary Edgeworth, PT
- Physical Therapist
- Traverse City, MI
National Provider Identifier
1548412588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501001820
- Practice address
- 1650 Barlow St
Traverse City, MI 49686-4721 - Phone
- (231) 941-3100
- Fax
- (231) 922-0382
- NPI assigned
- Oct 22, 2008
- 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 | 5501001820 | MI | Primary |
Addresses
Primary practice location
1650 Barlow St
Traverse City, MI 49686-4721
Mailing address
1650 Barlow St
Traverse City, MI 49686-4721
Phone (231) 941-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43-2035142 | Other | MI | TAX ID |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1548412588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 BARLOW ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496864721",
"telephone_number": "231-941-3100",
"fax_number": "231-922-0382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 BARLOW ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496864721",
"telephone_number": "231-941-3100",
"fax_number": "231-922-0382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGEWORTH",
"first_name": "CYNTHIA",
"middle_name": "MARY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-22",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501001820",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "43-2035142",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.