Individual provider Active NPI

Laura Ann Koch Cunningham, RPH

  • Pharmacist
  • Saint Marys, OH
National Provider Identifier
1447492541
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03216469 Issued in OH
Practice address
1502 Executive Dr
Saint Marys, OH 45885-3317
Phone
(419) 394-3542
NPI assigned
Apr 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03216469 OH Primary
Pharmacist 183500000X 26022252A IN

Addresses

Primary practice location

1502 Executive Dr
Saint Marys, OH 45885-3317

Mailing address

11216 Chariot CT
Fort Wayne, IN 46845-2112
Phone (260) 479-8030

Other names 1

  • Laura Ann Koch Former name

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26022252AINMDPharmacist
03216469OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Ohio Inc Past Accepting new patients

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": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238716800000",
    "number": "1447492541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 CHARIOT CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452112",
            "telephone_number": "260-479-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 EXECUTIVE DR",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458853317",
            "telephone_number": "419-394-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LAURA",
        "middle_name": "ANN KOCH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2009-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03216469",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26022252A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "KOCH",
            "middle_name": "ANN",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Marys, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.