Active NPI
Tammy L Cunningham, CRNA
- Certified Registered Nurse Anesthetist
- South Charleston, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 35349
- Practice address
- 4605 Maccorkle Ave SW
South Charleston, WV 25309-1311 - Phone
- (304) 766-3600
- NPI assigned
- Jul 17, 2006
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 35349 | WV | Primary |
Addresses
Primary practice location
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Mailing address
110 Roane St
Charleston, WV 25302-2334
Phone (304) 344-0096
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0068838000 | Medicaid | WV | |
| 001720704 | Other | WV | MSBCBS |
| 1071159 | Other | WV | WORKERS COMP INDIVIDUAL |
| 1071159 | Other | WV | BRICKSTREET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800
4605 Maccorkle Ave SW
Thomas Memorial Hospital
South Charleston, WV 25309-1398
Phone (304) 766-3600
Hospital & facility affiliations
- Thomas Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35349 | WV | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Area Medical Center, Inc. | Current | Accepting new patients | |
| Charleston Area Medical Center Inc | Current | Accepting new patients | |
| THS Physician Partners Inc | Current | Accepting new patients | |
| Day Surgery Limited Liability | Past | Accepting new patients | |
| Mid-Atlantic Anesthesia Consultants, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
L3539
Columbus, OH 43260
Phone (304) 414-4800
501 Morris St
Charleston, WV 25301
Phone (304) 348-6293
3100 Maccorkle Ave SE
Ste 203
Charleston, WV 25304
Phone (304) 345-8820
1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700
4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- South Charleston, WV
- NPI 1871866806
-
- Anesthesiology Physician
- Charleston, WV
- NPI 1720035827
-
- General Acute Care Hospital
- Charleston, WV
- NPI 1124248752
-
- Multi-Specialty Clinic/Center
- Belpre, OH
- NPI 1588422547
-
- Ambulatory Surgical Clinic/Center
- Charleston, WV
- NPI 1730296997
-
- Anesthesiology Physician
- Hurricane, WV
- NPI 1144248907
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- South Charleston, WV
- NPI 1316925506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1104844109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ROANE ST",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253022334",
"telephone_number": "304-344-0096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4605 MACCORKLE AVE SW",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253091311",
"telephone_number": "304-766-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "TAMMY",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WV",
"license": "35349",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0068838000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MSBCBS",
"identifier": "001720704",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP INDIVIDUAL",
"identifier": "1071159",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRICKSTREET",
"identifier": "1071159",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.