Individual provider Active NPI

Pamela Shenouda Cunningham, MD

  • Pain Medicine (Anesthesiology) Physician
  • Odessa, TX
National Provider Identifier
1417948209
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
M0387 Issued in TX
Practice address
600 N Grant Ave
Odessa, TX 79761-4503
Phone
(432) 331-1234
Fax
(432) 331-1265
NPI assigned
Nov 2, 2005
Last updated
May 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X M0387 TX Primary

Addresses

Primary practice location

600 N Grant Ave
Odessa, TX 79761-4503

Mailing address

PO Box 1808
Odessa, TX 79760-1808
Phone (432) 331-1234

Other identifiers 1

IdentifierTypeStateIssuer
174108401MedicaidTX

Other names 1

  • Pamela Emad Shenouda Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 13, 2016 through Jan 13, 2028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Care I, Inc Past Accepting new patients
Benjamin J. Cunningham, M.D., P.a. Past Accepting new patients
Cambridge Public Health Commission Past Accepting new patients
Pamela S. Cunningham, M.D., P.a. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1417948209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1808",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797601808",
            "telephone_number": "432-331-1234",
            "fax_number": "432-331-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GRANT AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614503",
            "telephone_number": "432-331-1234",
            "fax_number": "432-331-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "PAMELA",
        "middle_name": "SHENOUDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "M0387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174108401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "SHENOUDA",
            "middle_name": "EMAD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.