Individual provider Active NPI

Jack R Cunningham, MD

  • Diagnostic Radiology Physician
  • Mobile, AL
National Provider Identifier
1144201526
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11495 Issued in AL
Practice address
5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone
(251) 544-1926
Fax
(251) 460-2846
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11495 AL Primary

Addresses

Primary practice location

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Mailing address

PO Box 9369
Mobile, AL 36691-0369
Phone (251) 544-1926

Other identifiers 3

IdentifierTypeStateIssuer
000017031MedicaidAL
104547MedicaidAL
009935328MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060322000224 AL Practitioner - Diagnostic Radiology 5597773291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.02 of 100Reported as group
Quality
98.57
Improvement activities
40
Cost
92.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11495ALMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Coastal Radiology, PC CurrentSince Nov 11, 1996 Accepting new patients

Locations

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01E0
  • bcbs alabama network 01G0
  • bcbs alabama network 01C0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1144201526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9369",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366910369",
            "telephone_number": "251-544-1926",
            "fax_number": "251-460-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MOBILE INFIRMARY CIR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073513",
            "telephone_number": "251-544-1926",
            "fax_number": "251-460-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JACK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "11495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000017031",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104547",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009935328",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.