Individual provider Active NPI

Scott L Cunningham, MD

  • Psychiatry Physician
  • Greensboro, NC
National Provider Identifier
1336136126
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
27905 Issued in NC
Practice address
600 Green Valley Rd
Suite 204
Greensboro, NC 27408-7700
Phone
(336) 292-1510
Fax
(336) 292-0679
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 27905 NC Primary

Addresses

Primary practice location

600 Green Valley Rd
Suite 204
Greensboro, NC 27408-7700

Mailing address

600 Green Valley Rd
Suite 204
Greensboro, NC 27408-7700
Phone (336) 292-1510

Other identifiers 1

IdentifierTypeStateIssuer
7926466MedicaidNC

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27905NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Psychiatric Group, PA Psychiatry Past Accepting new patients
Moses Cone Affiliated Physicians, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336136126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GREEN VALLEY RD",
            "address_2": "SUITE 204",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087700",
            "telephone_number": "336-292-1510",
            "fax_number": "336-292-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GREEN VALLEY RD",
            "address_2": "SUITE 204",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087700",
            "telephone_number": "336-292-1510",
            "fax_number": "336-292-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SCOTT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "27905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7926466",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.