Active NPI
Jason Blandon Cunningham, D.C.
- Chiropractor
- Oswego, NY
National Provider Identifier
1215078035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X011473
- Practice address
- 89 W Bridge St
Oswego, NY 13126-2144 - Phone
- (315) 383-9614
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH8574 | FL | |
| Chiropractor | 111N00000X | X011473 | NY | Primary |
Addresses
Primary practice location
89 W Bridge St
Oswego, NY 13126-2144
Mailing address
89 W Bridge St
Oswego, NY 13126-2144
Phone (315) 383-9614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080409000278 | NY | Practitioner - Chiropractic | 0547241630 | Practice locations: Fulton, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH8574 | FL | MD | Chiropractor |
| X011473 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292976000000",
"number": "1215078035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 W BRIDGE ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131262144",
"telephone_number": "315-383-9614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 W BRIDGE ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131262144",
"telephone_number": "315-383-9614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "JASON",
"middle_name": "BLANDON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2010-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH8574",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X011473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.