Individual provider Active NPI

Cynthia D. McInnis, PT

  • Physical Therapist
  • Roswell, NM
National Provider Identifier
1760536973
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
381 Issued in NM
Practice address
227 N Main St
Roswell, NM 88201-4722
Phone
(575) 625-2525
Fax
(575) 627-5934
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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 381 NM Primary

Addresses

Primary practice location

227 N Main St
Roswell, NM 88201-4722

Mailing address

227 N Main St
Roswell, NM 88201-4722
Phone (575) 625-2525

Other identifiers 1

IdentifierTypeStateIssuer
72989MedicaidNM

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
381NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Needs Consulting LLC CurrentSince Feb 26, 2013 Accepting new patients

Locations

227 N Main St
Roswell, NM 88201
Phone (575) 420-9380

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1760536973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014722",
            "telephone_number": "575-625-2525",
            "fax_number": "575-627-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014722",
            "telephone_number": "575-625-2525",
            "fax_number": "575-627-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "CYNTHIA",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72989",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.