Individual provider Active NPI

Jason L Cunningham

  • Nurse Practitioner
  • Columbia, TN
National Provider Identifier
1285004085
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20553 Issued in TN
Practice address
1222 Trotwood Ave
Suite 101
Columbia, TN 38401-6436
Phone
(931) 490-7348
Fax
(931) 490-7349
NPI assigned
Oct 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 20553 TN Primary

Addresses

Primary practice location

1222 Trotwood Ave
Suite 101
Columbia, TN 38401-6436

Mailing address

854 W James Campbell Blvd
Sutie 303
Columbia, TN 38401-4659
Phone (931) 490-7348

Other identifiers 1

IdentifierTypeStateIssuer
3710089MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, SD, MT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20151119001372 TN Practitioner - Nurse Practitioner 1759681950 Reassigns benefits to 4 organizations
I20250509002258 SD Practitioner - Nurse Practitioner 1759681950 Reassigns benefits to 2 organizations
I20250702001092 MT Practitioner - Nurse Practitioner 1759681950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roundup Memorial Hospital Association 12 clinicians
Maury Regional Medical Group, Inc 119 clinicians
Winner Regional Healthcare Center 14 clinicians

Practice addresses (Care Compare)

1207 2ND St W
Roundup, MT 59072-1835
Phone (406) 323-2301

1224 N Trotwood Ave
Columbia, TN 38401-4802

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

745 E 8TH St
Winner, SD 57580-2677
Phone (605) 842-7100

854 W James Campbell
Suite 303
Columbia, TN 38401-4672

854 W James Campbell Blvd
Columbia, TN 38401-4672
Phone (931) 388-8779

Hospital & facility affiliations

  • Winner Regional Healthcare Center - Cah Hospital, Winner, SD, CCN 431334
  • Maury Regional Hospital Hospital, Columbia, TN, CCN 440073
  • Rainy Lake Medical Center Hospital, International Falls, MN, CCN 241322
  • Roundup Memorial Healthcare Hospital, Roundup, MT, CCN 271346
  • Winner Regional Healthcare Center - Cah Nursing home, CCN 43Z334
  • Rainy Lake Medical Center Nursing home, CCN 24Z322

Merit-based Incentive Payment System (MIPS)

Final score
69.45 of 100Reported as group
Quality
42.88
Promoting interoperability
77
Improvement activities
40
Cost
74.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20553TNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southland TN Emergency Medical Services LLC CurrentSince Feb 3, 2025 Accepting new patients
Roundup Memorial Hospital Association CurrentSince May 1, 2025 Accepting new patients
Maury Regional Medical Group, Inc CurrentSince Oct 12, 2015 Accepting new patients
Apogee Medical Group Tennessee PC CurrentSince Nov 1, 2023 Accepting new patients
Maury Regional Hospital Marshall Medical Center CurrentSince Oct 12, 2015 Accepting new patients
Winner Regional Healthcare Center CurrentSince May 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 19, 2015 Accepting new patients
Roundup Memorial Hospital Association CurrentSince May 1, 2025 Accepting new patients
Winner Regional Healthcare Center CurrentSince May 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 19, 2015 Accepting new patients

Locations

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

435 S Crystal St
Ste 300
Butte, MT 59701
Phone (406) 496-3600

46 Village Loop Rd
Kalispell, MT 59901
Phone (406) 257-4001

2600 Wilson St
Miles City, MT 59301
Phone (406) 233-2500

1207 2nd St W
Roundup, MT 59072
Phone (406) 323-2301

1202 3rd St W
Roundup, MT 59072
Phone (406) 323-2301

745 E 8th St
Winner, SD 57580
Phone (605) 842-2626

1222 Trotwood Ave
Ste 503
Columbia, TN 38401
Phone (931) 380-9166

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

1222 Trotwood Ave
Ste 101
Columbia, TN 38401
Phone (931) 490-7348

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

1265 E College St
Pulaski, TN 38478
Phone (931) 363-7531

103 Jv Mangubat Dr
Waynesboro, TN 38485
Phone (931) 722-3404

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1285004085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 W JAMES CAMPBELL BLVD",
            "address_2": "SUTIE 303",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014659",
            "telephone_number": "931-490-7348",
            "fax_number": "931-490-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 TROTWOOD AVE",
            "address_2": "SUITE 101",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384016436",
            "telephone_number": "931-490-7348",
            "fax_number": "931-490-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JASON",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "20553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710089",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.