NPIMap

Individual provider Active NPI

Mark L Cunningham, MD

  • Physical Medicine & Rehabilitation Physician
  • Southaven, MS
National Provider Identifier
1326041146
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
16101 Issued in TN
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(901) 291-2427
NPI assigned
May 24, 2005
Last updated
Jan 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 16101 TN Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

880 Greenleaf Rd
Coldwater, MS 38618-8133
Phone (901) 291-2400

Other identifiers 2

IdentifierTypeStateIssuer
00112219MedicaidMS
3020096MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100105000296 TN Practitioner - Physical Medicine and Rehabilitation 7113068735 Reassigns benefits to 1 organization
I20110118000842 MS Practitioner - Physical Medicine and Rehabilitation 7113068735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1240 S Germantown Rd
Germantown, TN 38138-2226
Phone (901) 275-3300

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as individual
Quality
90
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16101TNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cunningham Physical Medicine Physical Medicine & Rehabilitation CurrentSince Sep 1, 1990 Accepting new patients
Baptist Memorial Hospital-Desoto, Inc, Past Accepting new patients

Locations

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

Interoperability endpoints

  • Direct secure messaging: mcunningham11579@direct.bmhcc.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1326041146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 GREENLEAF RD",
            "city": "COLDWATER",
            "state": "MS",
            "postal_code": "386188133",
            "telephone_number": "901-291-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "901-291-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "16101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112219",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020096",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.