Individual provider Active NPI

Ashley Nicole Cunningham, NP

  • Gerontology Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1275146201
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1058063 Issued in TX
Practice address
250 Miron Dr
Southlake, TX 76092-7852
Phone
(817) 328-3000
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 984596 VA
Gerontology Nurse Practitioner 363LG0600X 1058063 TX Primary

Addresses

Primary practice location

250 Miron Dr
Southlake, TX 76092-7852

Mailing address

250 Miron Dr
Southlake, TX 76092-7852
Phone (817) 328-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001004416 TX Practitioner - Nurse Practitioner 8325579337 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
984596VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services of Texas, P.a. CurrentSince Nov 1, 2025 Accepting new patients
West Coast Wound and Skin Care Inc CurrentSince Aug 19, 2025 Accepting new patients
Global Open Wound Care PLLC CurrentSince Aug 1, 2024 Accepting new patients
Applebaum Physiatry PLLC Gerontology CurrentSince Jan 23, 2025 Accepting new patients
Global Open Wound Care Services LLC CurrentSince Jan 26, 2025 Accepting new patients

Locations

2501 W Burbank Blvd
Ste 200
Burbank, CA 91505
Phone (818) 732-8272

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

101 E Ridge Rd
McAllen, TX 78503
Phone (956) 632-6000

11106 Christus Hls
San Antonio, TX 78251
Phone (210) 240-8241

7302 Oak Manor Dr
San Antonio, TX 78229
Phone (210) 334-8537

250 Miron Dr
Southlake, TX 76092
Phone (817) 328-3000

Organizations & group practices 5

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": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1275146201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MIRON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927852",
            "telephone_number": "817-328-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MIRON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927852",
            "telephone_number": "817-328-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "984596",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1058063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.