Keith Wayne Cunningham, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25186 Issued in AZ

Practice address

1526 W Glendale Ave Ste 104
Phoenix, AZ 85021-8576

Phone

(602) 867-2838

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1285796185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 W GLENDALE AVE STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218576",
            "telephone_number": "602-315-9689",
            "fax_number": "602-867-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 W GLENDALE AVE STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218576",
            "telephone_number": "602-867-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KEITH",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "25186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathleen Cunningham, PT
• Cody Alan Cunningham, MD, PHD
• Douglas L Cunningham, D.O.
• Geoffrey Richard Cunningham, FNP
• Jacquelynn Daleen Cunningham, RPH
• Megan Cunningham
• Renee Moreau Cunningham, MFT
• Roger Cunningham
• Sarah Cunningham, OTD, OTR/L
• Claymore Cuny, PHARMD

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.