Individual provider Active NPI

Jessica A Cunningham

  • Licensed Practical Nurse
  • Phoenixville, PA
National Provider Identifier
1285996793
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN290727 Issued in PA
Practice address
1288 Valley Forge Rd
Unit 69
Phoenixville, PA 19460-2687
Phone
(610) 933-9483
Fax
(610) 933-4080
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN290727 PA Primary

Addresses

Primary practice location

1288 Valley Forge Rd
Unit 69
Phoenixville, PA 19460-2687

Mailing address

48 S Wycombe Ave
Apt. 17
Lansdowne, PA 19050-2860
Phone (215) 500-1988

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

State licenses

LicenseStateTypeSpecialty
PN290727PAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1285996793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 S WYCOMBE AVE",
            "address_2": "APT. 17",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190502860",
            "telephone_number": "215-500-1988",
            "fax_number": "610-933-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 VALLEY FORGE RD",
            "address_2": "UNIT 69",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194602687",
            "telephone_number": "610-933-9483",
            "fax_number": "610-933-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JESSICA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN290727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.