Active NPI
Jay Eric Cunningham, D.P.M.
- Podiatrist
- Connellsville, PA
National Provider Identifier
1306800073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC004557R
- Practice address
- 2616 Memorial Blvd
D
Connellsville, PA 15425-1418 - Phone
- (724) 626-7620
- Fax
- (724) 626-1338
- NPI assigned
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC004557R | PA | Primary |
Addresses
Primary practice location
2616 Memorial Blvd
D
Connellsville, PA 15425-1418
Mailing address
2616 Memorial Blvd
D
Connellsville, PA 15425-1418
Phone (724) 626-7620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017463070004 | Medicaid | PA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1306800073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2616 MEMORIAL BLVD",
"address_2": "D",
"city": "CONNELLSVILLE",
"state": "PA",
"postal_code": "154251418",
"telephone_number": "724-626-7620",
"fax_number": "724-626-1338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2616 MEMORIAL BLVD",
"address_2": "D",
"city": "CONNELLSVILLE",
"state": "PA",
"postal_code": "154251418",
"telephone_number": "724-626-7620",
"fax_number": "724-626-1338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "JAY",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC004557R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017463070004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Connellsville, PA
- Connellsville Counseling Center, Inc (The Stern Center for Developmental and Behavioral Health, Inc.)
- Connellsville Counseling Center, Inc. (The Stern Center for Developmental and Behavioral Health)
- Nadene B Copeland, NP-C
- Matthew T Cramer, DPT
- Lorri Jeanne Cunningham-Kaylor, LPC, NCC
- Paul Dascani, M.D.
- Keli Dawn De Carlo, LPC, NCC
- Jasmine Lynn Debeary, MSW
- Maurita Decara, OTR/L
- Anthony Joseph Decarlo, M.S., LAT, ATC, CES
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.