Dustin Cunningham, DC
Individual provider Active NPI Chiropractor · Lagrange, IN
NPI 1265183263 · NPPES record last updated Jan 12, 2022
Key facts
- NPI
- 1265183263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08003275A (IN)
- Practice address
- 400 Union St
Lagrange, IN 46761-2286 - Phone
- (260) 499-4911
- NPI assigned
- Jan 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Waggoner and Waggoner DC LLC
Practice addresses (Care Compare)
400 Union St
Lagrange, IN 46761-2286
Phone (260) 499-4911
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220125001282 | IN | Practitioner - Chiropractic | 1557753522 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08003275A | IN | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08003275A | IN | Yes |
Addresses
Primary practice location
400 Union St
Lagrange, IN 46761-2286
Mailing address
209 Clark St
Kendallville, IN 46755-2262
Phone (260) 585-3871
Other practice location 1
209 Clark St
Kendallville, IN 46755-2262
Phone (260) 585-3871
Other providers in Lagrange, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.