Individual provider Active NPI

Cindy L Cunningham, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dover, DE
National Provider Identifier
1447277207
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
L8-0000132 Issued in DE
Practice address
156 S State Street Aly
Dover, DE 19904-7348
Phone
(302) 674-2380
Fax
(302) 674-1299
NPI assigned
Jul 17, 2006
Last updated
Oct 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0000132 DE Primary

Addresses

Primary practice location

156 S State Street Aly
Dover, DE 19904-7348

Mailing address

156 S State Street Aly
Dover, DE 19904-7348
Phone (302) 674-2380

Other identifiers 2

IdentifierTypeStateIssuer
1447277207MedicaidDE
AN0423OtherDECSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20070105000442 DE Practitioner - Certified Clinical Nurse Specialist (CNS) 5597765057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Mind and Body Consortium, LLC.Group PAC ID 9739234014, 19 clinicians

Practice addresses (Care Compare)

156 S State St
Dover, DE 19901-7314
Phone 302674238039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
L8-0000132DEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Mind and Body Consortium, LLC. Psychiatric/Mental Health, Adult CurrentSince Feb 20, 2021 Accepting new patients
Vista Medical Services, Inc. Past Accepting new patients

Locations

1151 Walker Rd
Dover, DE 19904
Phone (302) 674-1397

156 S State St
Dover, DE 19901
Phone 30267423801218

118 Sandhill Dr
Ste 201
Middletown, DE 19709
Phone 3024499314108

Organizations & group practices 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1447277207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 S STATE STREET ALY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047348",
            "telephone_number": "302-674-2380",
            "fax_number": "302-674-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S STATE STREET ALY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047348",
            "telephone_number": "302-674-2380",
            "fax_number": "302-674-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "CINDY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-10-18",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0000132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447277207",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSA",
            "identifier": "AN0423",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.