Individual provider Active NPI

Stephanie Cunningham, FNP-C

  • Family Nurse Practitioner
  • Edna, TX
National Provider Identifier
1376942318
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP125917 Issued in TX
Practice address
1013 S Wells St
Edna, TX 77957-4045
Phone
(361) 782-7800
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP125917 TX Primary

Addresses

Primary practice location

1013 S Wells St
Edna, TX 77957-4045

Mailing address

1013 S Wells St
Edna, TX 77957-4045
Phone (361) 782-7800

Other names 1

  • Stephanie Horton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141218001294 TX Practitioner - Nurse Practitioner 7911220280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson County Hospital District 20 clinicians

Practice addresses (Care Compare)

1013 A S Wells St
Edna, TX 77957-4045

1013 S Wells St
Edna, TX 77957-4045
Phone (361) 782-7800

Hospital & facility affiliations

  • Jackson County Home Health Home health agency, Edna, TX, CCN 677103
  • Palacios Community Medical Center Hospital, Palacios, TX, CCN 451332
  • De Tar Hospital Navarro Hospital, Victoria, TX, CCN 450147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP125917TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Hospital District Current Accepting new patients
Jackson County Hospital District CurrentSince Jan 1, 2024 Accepting new patients
Jackson County Hospital District CurrentSince Jan 1, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

1013A S Wells St
Edna, TX 77957
Phone (361) 782-3560

1013 S Wells St
Edna, TX 77957
Phone (361) 782-5241

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1376942318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 S WELLS ST",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779574045",
            "telephone_number": "361-782-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 S WELLS ST",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779574045",
            "telephone_number": "361-782-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "STEPHANIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HORTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edna, TX

Sources for this page

Verify at the official NPI Registry.