Samuel Adam Cundiff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3445 Issued in KY

Practice address

1350 Bull Lea Rd
Lexington, KY 40511-1247

Phone

(859) 246-8000

Fax

(859) 246-8032

NPI assigned

Jan 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1003677121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 RUBY RIVER DR APT 1103",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405116524",
            "telephone_number": "859-475-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BULL LEA RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111247",
            "telephone_number": "859-246-8000",
            "fax_number": "859-246-8032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 Fallow Cir",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403247007",
            "country_code": "US",
            "telephone_number": "859-475-6773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNDIFF",
        "first_name": "SAMUEL",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-16",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA3445",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA3445",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Renee Cummins, PA
• James Michael Cummins, BS, LMT
• Megan Cummins, PHARMD
• Tomarrah L Cummins, CRNA
• Ashleigh Nicole Cundiff, TCADC
• Trisha L Cunnagin, DMD
• Cassidi Aleeyah Oslonian Cunningham, BSN, RN
• Jaylee Cunningham, MA, LMFT
• Jennifer Rhea Cunningham, BS, MA
• Lindsey S Cunningham, FNP-BC

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.