Active NPI
Jessica Cunningham, OTR/L
- Occupational Therapist
- Gorham, NH
National Provider Identifier
1003030552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1704
- Practice address
- 10 Madison Ave
Gorham, NH 03581-1107 - Phone
- (603) 723-3123
- NPI assigned
- Apr 13, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 3889 | TN | |
| Occupational Therapist | 225X00000X | 1704 | NH | Primary |
Addresses
Primary practice location
10 Madison Ave
Gorham, NH 03581-1107
Mailing address
168 Hopkinton Rd
Concord, NH 03301-7911
Phone (603) 723-3123
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 |
|---|---|---|---|
| 1704 | NH | MD | General Practice Dentistry |
| 3889 | TN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578873600000",
"number": "1003030552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 HOPKINTON RD",
"city": "CONCORD",
"state": "NH",
"postal_code": "033017911",
"telephone_number": "603-723-3123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MADISON AVE",
"city": "GORHAM",
"state": "NH",
"postal_code": "035811107",
"telephone_number": "603-723-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "JESSICA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "3889",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NH",
"license": "1704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gorham, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.