Individual provider Active NPI

Corina Christine Cunningham, PA-C

  • Medical Physician Assistant
  • Chandler, AZ
National Provider Identifier
1205205010
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6177 Issued in AZ
Practice address
255 S Dobson Rd
Ste 1
Chandler, AZ 85224
Phone
(480) 722-2595
Fax
(480) 722-2599
NPI assigned
Sep 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6177 AZ Primary

Addresses

Primary practice location

255 S Dobson Rd
Ste 1
Chandler, AZ 85224

Mailing address

255 S Dobson Rd
Ste 1
Chandler, AZ 85224-6231
Phone (480) 722-2595

Other practice location 1

6555 E Southern Ave
#Ko3
Mesa, AZ 85206-3718
Phone (480) 295-3430

Other names 1

  • Ms. Corina Christine Williams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190527000007 AZ Practitioner - Physician Assistant 6901199298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Homan Hajbandeh MD PLLCGroup PAC ID 5991789463, 6 clinicians
George Roso, M.D., P.L.L.CGroup PAC ID 8224112313, 6 clinicians

Practice addresses (Care Compare)

255 S Dobson Rd
Suite 1
Chandler, AZ 85224-6231
Phone (480) 722-2595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6177AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Momdoc, LLC Medical PastSince Jul 1, 1998 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFEDBA/Endpoint/GFEDBA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1205205010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S DOBSON RD",
            "address_2": "STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246231",
            "telephone_number": "480-722-2595",
            "fax_number": "480-722-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S DOBSON RD",
            "address_2": "STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-722-2595",
            "fax_number": "480-722-2599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6555 E Southern Ave",
            "address_2": "#KO3",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852063718",
            "country_code": "US",
            "telephone_number": "480-295-3430",
            "fax_number": "888-846-8757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "CORINA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINA",
            "last_name": "WILLIAMS",
            "middle_name": "CHRISTINE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.