Individual provider Active NPI

Nancy Marie Cunningham, M.D.

  • Dermatology Physician
  • Wilmington, NC
National Provider Identifier
1407817299
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
200300330 Issued in NC
Practice address
6781 Parker Farm Dr
Suite 300
Wilmington, NC 28405-3161
Phone
(910) 763-1555
Fax
(910) 762-4726
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 200300330 NC Primary

Addresses

Primary practice location

6781 Parker Farm Dr
Suite 300
Wilmington, NC 28405-3161

Mailing address

6781 Parker Farm Dr
Suite 300
Wilmington, NC 28405-3161
Phone (910) 763-1555

Other identifiers 4

IdentifierTypeStateIssuer
13384OtherNCBCBS STATE
13384OtherNCBCBS FEDERAL
13384OtherNCBCBS NC
P00078702OtherNCRRMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000386 NC Practitioner - Dermatology 2163431602 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200300330NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, PA Dermatology CurrentSince Sep 8, 2003 Accepting new patients

Locations

6781 Parker Farm Dr
Ste 300
Wilmington, NC 28405
Phone (910) 763-1555

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1407817299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6781 PARKER FARM DR",
            "address_2": "SUITE 300",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053161",
            "telephone_number": "910-763-1555",
            "fax_number": "910-762-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6781 PARKER FARM DR",
            "address_2": "SUITE 300",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053161",
            "telephone_number": "910-763-1555",
            "fax_number": "910-762-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "NANCY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "200300330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS STATE",
            "identifier": "13384",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEDERAL",
            "identifier": "13384",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "13384",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "P00078702",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.