Individual provider Active NPI

Patricia Davis Cunningham, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Somerset, KY
National Provider Identifier
1003477381
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3013525 Issued in KY
Practice address
130 Southern School Rd
Somerset, KY 42501
Phone
(606) 679-4782
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3013525 KY Primary

Addresses

Primary practice location

130 Southern School Rd
Somerset, KY 42501

Mailing address

130 Southern School Rd
Somerset, KY 42501-3223
Phone (606) 679-4782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826003844 KY Practitioner - Nurse Practitioner 4587992771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

119 Herrifords Cir
Jamestown, KY 42629-2520
Phone (270) 343-2551

163 Herrifords Cir
Jamestown, KY 42629-2520
Phone (270) 343-4108

200 E Frazier Ave
Columbia, KY 42728-1915
Phone (270) 384-4719

218 Columbia Ave
Glasgow, KY 42141-2932
Phone (270) 651-7070

322 Middleburg St
Liberty, KY 42539-3004
Phone (606) 787-9472

521 Old Hodgenville Rd
Greensburg, KY 42743-9493
Phone (270) 932-3647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013525KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional Mental Health Mental Retardation Board, Inc. CurrentSince Jul 8, 2019 Accepting new patients
Lake Cumberland Regional MHMR Board Outpatient Past Accepting new patients

Locations

200 E Frazier Ave
Columbia, KY 42728
Phone (270) 384-4710

119 Herrifords Cir
Jamestown, KY 42629
Phone (270) 343-2551

130 Southern School Rd
Somerset, KY 42501
Phone (606) 679-4782

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/caseyco-4151b385

Organizations & group practices 2

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1003477381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SOUTHERN SCHOOL RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013223",
            "telephone_number": "606-679-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SOUTHERN SCHOOL RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42501",
            "telephone_number": "606-679-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "PATRICIA",
        "middle_name": "DAVIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3013525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.