Individual provider Active NPI

Braden Cunningham

  • Student in an Organized Health Care Education/Training Program
  • Ogden, UT
National Provider Identifier
1205414117
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3903 Medical Dr Ste 200
Ogden, UT 84403-2318
Phone
(801) 387-5300
Fax
(801) 387-5333
NPI assigned
Mar 31, 2021
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UT Primary
Technician/Technologist 156F00000X
Histology Technician 246RH0600X

Addresses

Primary practice location

3903 Medical Dr Ste 200
Ogden, UT 84403-2318

Mailing address

3903 Medical Dr Ste 200
Ogden, UT 84403-2318
Phone (801) 387-5300

Other identifiers 1

IdentifierTypeStateIssuer
802003707OtherUTSELECT HEALTH

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

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1205414117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 MEDICAL DR STE 200",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032318",
            "telephone_number": "801-387-5300",
            "fax_number": "801-387-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 MEDICAL DR STE 200",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032318",
            "telephone_number": "801-387-5300",
            "fax_number": "801-387-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "BRADEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": true
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RH0600X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Histology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "802003707",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.