Active NPI
Jordan Cunningham, RPH
- Pharmacist
- Lakewood, OH
National Provider Identifier
1245896810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03333956
- Practice address
- 16207 Detroit Ave
Lakewood, OH 44107-3784 - Phone
- (216) 521-8826
- NPI assigned
- May 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03333956 | OH | Primary |
Addresses
Primary practice location
16207 Detroit Ave
Lakewood, OH 44107-3784
Mailing address
16207 Detroit Ave
Lakewood, OH 44107-3784
Phone (216) 521-8826
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03333956 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558224000000",
"number": "1245896810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16207 DETROIT AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073784",
"telephone_number": "216-521-8826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16207 DETROIT AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073784",
"telephone_number": "216-521-8826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "JORDAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-19",
"last_updated": "2019-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03333956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.