Individual provider Active NPI

Liam Christopher Cunningham, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1508472622
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116353 Issued in FL
Practice address
8108 N Nebraska Ave
Tampa, FL 33604-3103
Phone
(813) 397-5300
Fax
(813) 712-1929
NPI assigned
Sep 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1177293 PA
Physician Assistant 363A00000X PA9116353 FL Primary

Addresses

Primary practice location

8108 N Nebraska Ave
Tampa, FL 33604-3103

Mailing address

PO Box 82969
Tampa, FL 33682-2969
Phone (813) 866-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201215000215 PA Practitioner - Physician Assistant 9638581739 Reassigns benefits to 1 organization
I20221229000497 FL Practitioner - Physician Assistant 9638581739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Family Health Centers IncGroup PAC ID 1254243769, 66 clinicians

Practice addresses (Care Compare)

12085 W Hillsborough Ave
Tampa, FL 33635-9725
Phone (813) 852-5270

7814 N Dale Mabry Hwy
Tampa, FL 33614-3220
Phone (813) 397-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1177293PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Family Health Centers, Inc CurrentSince Nov 28, 2022 Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Nov 28, 2022 Accepting new patients

Locations

8108 N Nebraska Ave
Tampa, FL 33604
Phone (813) 712-1930

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 405-3939

12085 W Hillsborough Ave
Tampa, FL 33635
Phone (813) 852-5270

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1508472622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "813-866-0930",
            "fax_number": "813-405-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8108 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336043103",
            "telephone_number": "813-397-5300",
            "fax_number": "813-712-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LIAM",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "1177293",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.