NPIMap

Individual provider Active NPI

Kevin Ray Cunningham, D.O.

  • Family Medicine Physician
  • Eastland, TX
National Provider Identifier
1114054673
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M3506 Issued in TX
Practice address
400 W Plummer St
Eastland, TX 76448-2627
Phone
(254) 629-1744
Fax
(254) 629-3904
NPI assigned
Feb 28, 2007
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M3506 TX Primary

Addresses

Primary practice location

400 W Plummer St
Eastland, TX 76448-2627

Mailing address

PO Box 1429
Eastland, TX 76448-1429
Phone (254) 629-1744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000217 TX Practitioner - Family Practice 6305946039 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Concord Medical Group PLLCGroup PAC ID 0446296818, 189 clinicians
B and W Healthcare Associates PAGroup PAC ID 7416025457, 4 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

304 S Daugherty Ave
Eastland, TX 76448-2609
Phone (254) 629-2601

400 W Plummer
Eastland, TX 76448-2627
Phone (254) 629-1744

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions25
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Aug 28, 2021 Accepting new patients
B & W Healthcare Associates PA Family Medicine CurrentSince Aug 1, 2008 Accepting new patients
South Central Physicians PLLC CurrentSince Jan 21, 2025 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Aug 28, 2021 Accepting new patients
B & W Clinic PA Family Medicine PastSince Aug 1, 2008 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

10201 Highway 16
Comanche, TX 76442
Phone (254) 879-4910

304 S Daugherty Ave
Eastland, TX 76448
Phone (254) 629-2601

400 W Plummer St
Eastland, TX 76448
Phone (254) 629-1744

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

4750 President George Bush Tpke
Sachse, TX 75048
Phone (214) 477-7647

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1114054673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1429",
            "city": "EASTLAND",
            "state": "TX",
            "postal_code": "764481429",
            "telephone_number": "254-629-1744",
            "fax_number": "254-629-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W PLUMMER ST",
            "city": "EASTLAND",
            "state": "TX",
            "postal_code": "764482627",
            "telephone_number": "254-629-1744",
            "fax_number": "254-629-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KEVIN",
        "middle_name": "RAY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastland, TX

Sources for this page

Verify at the official NPI Registry.