Individual provider Active NPI

Cynthia J Ginder, P.T.

  • Physical Therapist
  • Peoria, IL
National Provider Identifier
1962575795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
70001159 Issued in IL
Practice address
114 W Stratford Dr
Suite 2B
Peoria, IL 61614-7301
Phone
(309) 685-2855
Fax
(309) 685-2844
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 70001159 IL Primary

Addresses

Primary practice location

114 W Stratford Dr
Suite 2B
Peoria, IL 61614-7301

Mailing address

4 Timber Oaks Dr
Metamora, IL 61548-8508
Phone (309) 676-9010

Other identifiers 1

IdentifierTypeStateIssuer
0007227878OtherILBCBS PROVIDER NUMBER

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
70001159ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962575795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 TIMBER OAKS DR",
            "city": "METAMORA",
            "state": "IL",
            "postal_code": "615488508",
            "telephone_number": "309-676-9010",
            "fax_number": "309-367-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W STRATFORD DR",
            "address_2": "SUITE 2B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147301",
            "telephone_number": "309-685-2855",
            "fax_number": "309-685-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINDER",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70001159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0007227878",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.