NPIMap

Individual provider Active NPI

Abby L Cunningham, FNP

  • Family Nurse Practitioner
  • Jacksonville, IL
National Provider Identifier
1528299955
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209007687 Issued in IL
Practice address
1602 W Lafayette Ave
Jacksonville, IL 62650-1007
Phone
(217) 243-7200
Fax
(217) 245-6165
NPI assigned
Aug 3, 2009
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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 209007687 IL Primary

Addresses

Primary practice location

1602 W Lafayette Ave
Jacksonville, IL 62650-1007

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (800) 577-5368

Other identifiers 1

IdentifierTypeStateIssuer
F0709131OtherILANCC CERTIFICATION

Other names 1

  • Abby L Fry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522000886 IL Practitioner - Nurse Practitioner 7214190669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

101 E Plummer Blvd
Chatham, IL 62629-8047
Phone (217) 588-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic LLP Current Accepting new patients
Memorial Physician Services CurrentSince Jan 1, 2013 Accepting new patients
Memorial Health Partners Current Accepting new patients
Memorial Physician Services Current Accepting new patients
Memorial Physician Services CurrentSince Jan 1, 2013 Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Memorial Physician Services Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

15 Founders Ln
Ste 100
Jacksonville, IL 62650
Phone (217) 243-0300

1602 W Lafayette Ave
Jacksonville, IL 62650
Phone (217) 243-7200

1606 W Lafayette Ave
Jacksonville, IL 62650
Phone (217) 243-9091

Interoperability endpoints

  • Direct secure messaging: abbycunningham@memorial.allscriptsdirect.net
  • Direct secure messaging: abbycunningham@sfc.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1528299955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W LAFAYETTE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501007",
            "telephone_number": "217-243-7200",
            "fax_number": "217-245-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "ABBY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATION",
            "identifier": "F0709131",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "FRY",
            "middle_name": "L",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.