NPIMap

Organization Active NPI

Cunningham Pathology, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Tuscaloosa, AL
National Provider Identifier
1063418663
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
09953 Issued in AL
Legal business name
CUNNINGHAM PATHOLOGY, LLC
Practice address
902 Dr Edward Hillard Dr
Tuscaloosa, AL 35401-2083
Phone
(205) 759-7484
Fax
(205) 750-5224
NPI assigned
Jun 28, 2005
Organization subpart
Yes
Parent organization
CUNNINGHAM PATHOLOGY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Sheila Hall
Title
Credentialing Coordinator
Phone
(205) 591-7999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 09953 AL Primary

Addresses

Primary practice location

902 Dr Edward Hillard Dr
Tuscaloosa, AL 35401-2083

Mailing address

809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080218000071 AL Part B Supplier - Clinic/Group Practice 2668468802 Receives reassigned benefits from 18 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Birmingham, AL; Tuscaloosa, AL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Valerie R Wheeler-Mangi2 organizations share this tax ID, including this one
Part of
Valerie R Wheeler-Mangi

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

902 Dr Edward Hillard Dr
Tuscaloosa, AL 35401
Phone (205) 758-2794

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1063418663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012029",
            "telephone_number": "205-759-7484",
            "fax_number": "205-750-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 DR EDWARD HILLARD DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012083",
            "telephone_number": "205-759-7484",
            "fax_number": "205-750-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUNNINGHAM PATHOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CUNNINGHAM PATHOLOGY, LLC",
        "enumeration_date": "2005-06-28",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "205-591-7999"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AL",
            "license": "09953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.