Individual provider Active NPI

Julie Ann Cunningham, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1053864652
Registry record updated May 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60821011 Issued in WA
Practice address
1901 S Cedar St Ste 108
Tacoma, WA 98405-2302
Phone
(253) 212-0078
Fax
(253) 212-3877
NPI assigned
Jul 29, 2016
Reactivated
Jan 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60821011 WA Primary

Addresses

Primary practice location

1901 S Cedar St Ste 108
Tacoma, WA 98405-2302

Mailing address

10811 222ND Avenue CT E
Buckley, WA 98321-9486
Phone (253) 307-9874

Other practice location 1

10811 222nd Avenue Ct E
Buckley, WA 98321-9486
Phone (253) 307-9874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190613001579 WA Practitioner - Nurse Practitioner 7315270998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1430 3Rd St SE
Puyallup, WA 98372-3703
Phone (253) 799-8956

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cunningham Family Clinic PLLC Current Accepting new patients

Locations

1430 3rd St SE
Puyallup, WA 98372
Phone (253) 435-4100

Interoperability endpoints

  • Direct secure messaging: julie.cunningham.1@10025.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557532800000",
    "number": "1053864652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 222ND AVENUE CT E",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983219486",
            "telephone_number": "253-307-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S CEDAR ST STE 108",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052302",
            "telephone_number": "253-212-0078",
            "fax_number": "253-212-3877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10811 222nd Avenue Ct E",
            "address_purpose": "LOCATION",
            "city": "Buckley",
            "state": "WA",
            "postal_code": "983219486",
            "country_code": "US",
            "telephone_number": "253-307-9874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2019-05-11",
        "deactivation_date": "2018-01-08",
        "reactivation_date": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60821011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.