Individual provider Active NPI

Sherre Adukwa Cunningham, FNP-C

  • Family Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1518403054
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN203314 Issued in GA
Practice address
1255 Highway 54 W
Fayetteville, GA 30214
Phone
(770) 719-5630
Fax
(770) 719-5629
NPI assigned
Jan 9, 2017
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN203314 GA Primary

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214

Mailing address

1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-1175

Other practice location 1

1155 Perimeter Ctr
Atlanta, GA 30338-5463
Phone (404) 905-9179

Other names 1

  • Sherre Adukwa Henry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170310001238 GA Practitioner - Nurse Practitioner 8820372857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN203314GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Hospitalist Physicians LLC CurrentSince Feb 27, 2017 Accepting new patients

Locations

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

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, 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": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1518403054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-719-5630",
            "fax_number": "770-719-5629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Perimeter Ctr",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303385463",
            "country_code": "US",
            "telephone_number": "404-905-9179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SHERRE",
        "middle_name": "ADUKWA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN203314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRE",
            "last_name": "HENRY",
            "middle_name": "ADUKWA",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.