Individual provider Active NPI

Kristen Cunningham, PT, DPT

  • Physical Therapist
  • Bakersfield, CA
National Provider Identifier
1689144396
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT295977 Issued in CA
Practice address
3400 Calloway Dr Ste 603
Bakersfield, CA 93312-2514
Phone
(661) 377-1700
Fax
(661) 616-9199
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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 PT295977 CA Primary

Addresses

Primary practice location

3400 Calloway Dr Ste 603
Bakersfield, CA 93312-2514

Mailing address

3400 Calloway Dr Ste 603
Bakersfield, CA 93312-2514
Phone (661) 377-1700

Other names 1

  • Kristen Witchey Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122001755 UT Practitioner - Physical Therapist in Private Practice 0547508798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT295977CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountaintop Physical Therapy & Wellness Center, Inc. Physical Therapist CurrentSince Nov 12, 2021 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

1794 Olympic Pkwy
Ste 140
Park City, UT 84098
Phone (435) 575-0345

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.

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1689144396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR STE 603",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122514",
            "telephone_number": "661-377-1700",
            "fax_number": "661-616-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR STE 603",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122514",
            "telephone_number": "661-377-1700",
            "fax_number": "661-616-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KRISTEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "WITCHEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.