Active NPI
Cynthia J Ginder, P.T.
- Physical Therapist
- Peoria, IL
National Provider Identifier
1962575795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 70001159
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007227878 | Other | IL | BCBS 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
| License | State | Type | Specialty |
|---|---|---|---|
| 70001159 | IL | MD | Physical 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.