Active NPI
Gary William Cundiff Jr., PSYD
- Psychologist
- Chattanooga, TN
National Provider Identifier
1356302061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P0000001508
- Practice address
- 2000 Stein Drive
Chattanooga, TN 37421 - Phone
- (423) 648-8480
- Fax
- (423) 648-8481
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | P0000001508 | TN | Primary |
Addresses
Primary practice location
2000 Stein Drive
Chattanooga, TN 37421
Mailing address
P.O. Box 24387
Chattanooga, TN 37422
Phone (423) 648-8480
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3683849 | Medicaid | TN | |
| 000724248B | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000001508 | TN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology Consultants Exchange, PC | Past | Accepting new patients | |
| Anesthesiologists Associated PC | Past | Accepting new patients | |
| Anesthesiologists Associated PC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Certified Registered Nurse Anesthetist
- Chattanooga, TN
- NPI 1043278443
-
- Anesthesiology Physician
- Chattanooga, TN
- NPI 1518923705
-
- Anesthesiology Physician
- Chattanooga, TN
- NPI 1184670218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677715200000",
"number": "1356302061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 24387",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37422",
"telephone_number": "423-648-8480",
"fax_number": "423-648-8481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 STEIN DRIVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37421",
"telephone_number": "423-648-8480",
"fax_number": "423-648-8481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNDIFF",
"first_name": "GARY",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2023-03-02",
"certification_date": "2023-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TN",
"license": "P0000001508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3683849",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000724248B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.