Individual provider Active NPI

John David Cucinotta, P.T.

  • Physical Therapist
  • Cumming, GA
National Provider Identifier
1902060700
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007730 Issued in GA
Practice address
610 Peachtree Pkwy
Suite 101
Cumming, GA 30041-9712
Phone
(678) 455-5600
Fax
(678) 455-4554
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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 PT007730 GA Primary

Addresses

Primary practice location

610 Peachtree Pkwy
Suite 101
Cumming, GA 30041-9712

Mailing address

610 Peachtree Pkwy
Suite 101
Cumming, GA 30041-9712
Phone (678) 455-5600

Other identifiers 1

IdentifierTypeStateIssuer
611446156001OtherGATRICARE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT007730GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Forum of Georgia 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1902060700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PEACHTREE PKWY",
            "address_2": "SUITE 101",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419712",
            "telephone_number": "678-455-5600",
            "fax_number": "678-455-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PEACHTREE PKWY",
            "address_2": "SUITE 101",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419712",
            "telephone_number": "678-455-5600",
            "fax_number": "678-455-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCINOTTA",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "611446156001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.