Active NPI
McKenzie Cunningham
- Speech-Language Pathologist
- Abilene, TX
National Provider Identifier
1043857048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 112473
- Practice address
- 4545 Hartford St
Abilene, TX 79605-4602 - Phone
- (325) 793-3537
- NPI assigned
- Dec 9, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 112473 | TX | Primary |
Addresses
Primary practice location
4545 Hartford St
Abilene, TX 79605-4602
Mailing address
4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3537
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112473 | Medicaid | TX | |
| 112473 | Other | TX | COMMERCIAL INSURANCE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Abilene |
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 |
|---|---|---|---|
| 112473 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1043857048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 HARTFORD ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796054603",
"telephone_number": "325-793-3537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 HARTFORD ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796054602",
"telephone_number": "325-793-3537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "MCKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-09",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "112473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112473",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL INSURANCE",
"identifier": "112473",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Abilene",
"affiliation": "N",
"address_1": "4545 Hartford St",
"city": "Abilene",
"state": "TX",
"country_code": "US",
"postal_code": "796054602",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.