Individual provider Active NPI

Timothy Earl Cunningham, D.C.

  • Chiropractor
  • Mandeville, LA
National Provider Identifier
1346636149
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1775 Issued in LA
Practice address
69282 Highway 59 Ste 4
Mandeville, LA 70471-7676
Phone
(985) 951-2020
Fax
(985) 951-2025
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Chiropractor 111NI0013X 4762653906 LA
Chiropractor 111N00000X 1775 LA Primary

Addresses

Primary practice location

69282 Highway 59 Ste 4
Mandeville, LA 70471-7676

Mailing address

69282 Highway 59 Ste 4
Mandeville, LA 70471-7676
Phone (985) 951-2020

Other identifiers 2

IdentifierTypeStateIssuer
2449630MedicaidLA
4762653906OtherNRCME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171102001229 LA Practitioner - Chiropractic 6406177237 Reassigns benefits to 1 organization
Practice locations: Mandeville, LA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

69282 Hwy 59
Suite 4
Mandeville, LA 70471-7676
Phone (985) 951-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4762653906LAMDIndependent Medical Examiner Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Refining Essentials LLC Chiropractor CurrentSince Mar 1, 2019 Accepting new patients

Locations

69282 Highway 59
Ste 4
Mandeville, LA 70471
Phone (985) 469-1259

Organizations & group practices 1

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1346636149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69282 HIGHWAY 59 STE 4",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704717676",
            "telephone_number": "985-951-2020",
            "fax_number": "985-951-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69282 HIGHWAY 59 STE 4",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704717676",
            "telephone_number": "985-951-2020",
            "fax_number": "985-951-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "TIMOTHY",
        "middle_name": "EARL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "LA",
            "license": "4762653906",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2449630",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NRCME",
            "identifier": "4762653906",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.