Individual provider Active NPI

Tiffany Elaine Cunningham, RDMS

  • Diagnostic Ultrasound Physician
  • Bangor, ME
National Provider Identifier
1194237701
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
157553 Issued in ME
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 973-7471
NPI assigned
Nov 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 157553 ME Primary

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

15 Winchester St Apt 2
Fairfield, ME 04937-1314
Phone (207) 592-1838

Other practice location 1

35 Medical Center Pkwy
Augusta, ME 04330-8160
Phone (207) 624-4356

Other practice location 2

149 North St
Waterville, ME 04901-4974
Phone (207) 872-1119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
157553MEMDDiagnostic Ultrasound Physician

NPI Registry JSON

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194237701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WINCHESTER ST APT 2",
            "city": "FAIRFIELD",
            "state": "ME",
            "postal_code": "049371314",
            "telephone_number": "207-592-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043308160",
            "country_code": "US",
            "telephone_number": "207-624-4356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "149 North St",
            "address_purpose": "LOCATION",
            "city": "Waterville",
            "state": "ME",
            "postal_code": "049014974",
            "country_code": "US",
            "telephone_number": "207-872-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "TIFFANY",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "RDMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "ME",
            "license": "157553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.