Individual provider Active NPI

Maria Dulce Carunungan, PT,DPT, MS, GCS, CWS

  • Physical Therapist
  • Beckley, WV
National Provider Identifier
1912174541
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
000791 Issued in WV
Practice address
347 A Rural Acres Drive
Beckley, WV 25801
Phone
(304) 237-6333
NPI assigned
May 13, 2008
Last updated
May 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305202126 VA
Physical Therapist 225100000X 000791 WV Primary
Geriatric Physical Therapist 2251G0304X 000791 WV

Addresses

Primary practice location

347 A Rural Acres Drive
Beckley, WV 25801

Mailing address

PO Box 452
Beckley, WV 25802-0452
Phone (304) 237-6333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260528002104 WV Practitioner - Physical Therapist in Private Practice 3375013600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Avery Olivia Way
Suite C
Fairmont, WV 26554-9375

415 Benedum Dr
Bridgeport, WV 26330-1503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2305202126VAMDPhysical Therapist
000791WVMDPhysical Therapist

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1912174541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258020452",
            "telephone_number": "304-237-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 A RURAL ACRES DRIVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "25801",
            "telephone_number": "304-237-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUNUNGAN",
        "first_name": "MARIA",
        "middle_name": "DULCE",
        "name_prefix": "Mrs.",
        "credential": "PT,DPT, MS, GCS, CWS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202126",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "000791",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WV",
            "license": "000791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.