NPIMap

Individual provider Active NPI

Cynthia Anderson, PT

  • Physical Therapist
  • Winchester, VA
National Provider Identifier
1619207800
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211804 Issued in VA
Practice address
400 Clocktower Ridge Dr
Winchester, VA 22603-3878
Phone
(888) 531-2204
Fax
(855) 232-8604
NPI assigned
Jan 11, 2010
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003917 WV
Physical Therapist 225100000X 2305211804 VA Primary
Physical Therapist 225100000X 26201 MD
Physical Therapist 225100000X DAPT002724 PA

Addresses

Primary practice location

400 Clocktower Ridge Dr
Winchester, VA 22603-3878

Mailing address

400 Clocktower Ridge Dr
Winchester, VA 22603-3878
Phone (888) 531-2204

Other names 1

  • Cynthia M Boudreau Former name

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
26201MDMDPhysical Therapist
DAPT002724PAMDPhysical Therapist
PT003917WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Therapy Works, Inc. Physical Therapist Past 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": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1619207800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CLOCKTOWER RIDGE DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226033878",
            "telephone_number": "888-531-2204",
            "fax_number": "855-232-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CLOCKTOWER RIDGE DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226033878",
            "telephone_number": "888-531-2204",
            "fax_number": "855-232-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CYNTHIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT003917",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211804",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26201",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "DAPT002724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "BOUDREAU",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.