NPIMap

Individual provider Active NPI

Loren N Cunningham, PAC

  • Medical Physician Assistant
  • Petersburg, WV
National Provider Identifier
1235408261
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
111 S Grove St Ste 1
Petersburg, WV 26847-1805
Phone
(304) 257-2451
NPI assigned
Dec 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 01564 WV
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

111 S Grove St Ste 1
Petersburg, WV 26847-1805

Mailing address

111 S Grove St Ste 1
Petersburg, WV 26847-1805
Phone (304) 257-2451

Other practice location 1

112 Kuykendall Lane
Love Memorial Clinic
Moorefield, WV 26836
Phone (304) 530-7755

Other names 1

  • Ms. Loren N Goodall Former name

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)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
E. a. Hawse Health Center, Inc. Past Accepting new patients
E. a. Hawse Health Center, Inc. Past Accepting new patients
E. a. Hawse Health Center, Inc. Past Accepting new patients
E.a. Hawse Health Center Inc. Past Accepting new patients

Organizations & group practices 4

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": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1235408261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S GROVE ST STE 1",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471805",
            "telephone_number": "304-257-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GROVE ST STE 1",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471805",
            "telephone_number": "304-257-2451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Kuykendall Lane",
            "address_2": "Love Memorial Clinic",
            "address_purpose": "LOCATION",
            "city": "Moorefield",
            "state": "WV",
            "postal_code": "26836",
            "country_code": "US",
            "telephone_number": "304-530-7755",
            "fax_number": "304-530-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LOREN",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-20",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01564",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOREN",
            "last_name": "GOODALL",
            "middle_name": "N",
            "prefix": "MS.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.