Ethan Brent Cunningham, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704328016 Issued in MI

Practice address

523 Edgeworthe Dr SE
Ada, MI 49301-7809

Phone

(616) 745-8097

NPI assigned

Aug 20, 2014

Last updated

May 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Valley State University

  dba Campus Health Center

  • Urgent Care Clinic/Center
  • Allendale, MI
  • NPI 1518019223

  Family

  Medicare reassignment NPD
• Hope Network - Rehabilitation Services

  • Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
  • Grand Rapids, MI
  • NPI 1528043544
  Medicare reassignment
• Hope Network Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Nunica, MI
  • NPI 1043295934
  Medicare reassignment
• Hope Network West Michigan

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Sparta, MI
  • NPI 1679558670
  Medicare reassignment

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1083013577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 EDGEWORTHE DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493017809",
            "telephone_number": "616-745-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 EDGEWORTHE DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493017809",
            "telephone_number": "616-745-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "ETHAN",
        "middle_name": "BRENT",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-20",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704328016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connection Counseling LLC
• Cheryl Lynn Cooper, LPC, LMFT
• Emily Cordes, DO
• Cornerstone Caregiving East LLC
• Kathleen Jandernoa Cramer, PHD, L.P.
• Conor Dahlquist
• Daniel K. Ehnis, PC
• Kristen Daniels, LMSW
• Stacy L Davis, O.D.
• Dawn Jenkins LMSW

• Primary Care Nurse Practitioner in Ada, MI
• Providers in Ada, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.