Individual provider Active NPI

Karen Roberts Cunningham, AGNP-C

  • Gerontology Nurse Practitioner
  • Hephzibah, GA
National Provider Identifier
1124985700
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN-NP217080 Issued in GA
Practice address
5440 Thrasher LN
Hephzibah, GA 30815-7221
Phone
(706) 284-5276
NPI assigned
Jan 6, 2026
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN-NP217080 GA Primary

Addresses

Primary practice location

5440 Thrasher LN
Hephzibah, GA 30815-7221

Mailing address

5440 Thrasher LN
Hephzibah, GA 30815-7221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260117000011 GA Practitioner - Nurse Practitioner 6406333756 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

115 Brentwood Dr
Waynesboro, GA 30830-4519
Phone (731) 394-1145

3051 Whiteside Rd
Macon, GA 31216-6209
Phone (877) 940-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP217080GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health Providers II LLC CurrentSince Jan 14, 2026 Accepting new patients
Ultra Health LLC CurrentSince Jan 26, 2026 Accepting new patients

Locations

1901 W Screven St
Quitman, GA 31643
Phone (229) 263-6100

115 Brentwood Dr
Waynesboro, GA 30830
Phone (706) 554-4425

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1767657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1124985700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 THRASHER LN",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308157221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 THRASHER LN",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308157221",
            "telephone_number": "706-284-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KAREN",
        "middle_name": "ROBERTS",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-06",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "APRN-NP217080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hephzibah, GA

Sources for this page

Verify at the official NPI Registry.