Organization Active NPI

Sandra K Cunningham, DC

  • Chiropractor
  • White Hall, WV
National Provider Identifier
1215131149
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
739 Issued in WV
Legal business name
SANDRA K CUNNINGHAM, DC
Practice address
158 Middletown Rd.
White Hall, WV 26554-8106
Phone
(304) 363-4343
Fax
(304) 367-9802
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Authorized official

Name
Ms. Monica Lynn Thompson
Title
Billing Coordinator
Phone
(304) 363-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 739 WV Primary

Addresses

Primary practice location

158 Middletown Rd.
White Hall, WV 26554-8106

Mailing address

158 Middletown Rd.
White Hall, WV 26554-8106
Phone (304) 363-4343

Other identifiers 1

IdentifierTypeStateIssuer
2202018000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000573 WV Part B Supplier - Clinic/Group Practice 8628047156 Receives reassigned benefits from 1 practitioner
Practice locations: Fairmont, WV

National Provider Directory

National Provider Directory

Locations

158 Middletown Rd
White Hall, WV 26554
Phone (304) 363-4343

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1215131149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 MIDDLETOWN RD.",
            "city": "WHITE HALL",
            "state": "WV",
            "postal_code": "265548106",
            "telephone_number": "304-363-4343",
            "fax_number": "304-367-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 MIDDLETOWN RD.",
            "city": "WHITE HALL",
            "state": "WV",
            "postal_code": "265548106",
            "telephone_number": "304-363-4343",
            "fax_number": "304-367-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA K CUNNINGHAM, DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "304-363-4343",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2202018000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Hall, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.

Verify at the official NPI Registry.