Individual provider Active NPI

Dennis Edward McCunniff, MD

  • Obstetrics & Gynecology Physician
  • Winston Salem, NC
National Provider Identifier
1518955962
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
26961 Issued in NC
Practice address
1806 S Hawthorne Rd
Winston Salem, NC 27103-4014
Phone
(336) 768-3632
Fax
(336) 736-4473
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 26961 NC Primary

Addresses

Primary practice location

1806 S Hawthorne Rd
Winston Salem, NC 27103-4014

Mailing address

1806 S Hawthorne Rd
Winston Salem, NC 27103-4014
Phone (336) 768-3632

Other identifiers 1

IdentifierTypeStateIssuer
8955961MedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26961NCMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1518955962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034014",
            "telephone_number": "336-768-3632",
            "fax_number": "336-736-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034014",
            "telephone_number": "336-768-3632",
            "fax_number": "336-736-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUNNIFF",
        "first_name": "DENNIS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "26961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8955961",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.