Individual provider Active NPI

Arwyn Grace Cunningham, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Davenport, IA
National Provider Identifier
1538514138
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
DO-06092 Issued in IA
Practice address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone
(563) 421-6772
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X SD
Student in an Organized Health Care Education/Training Program 390200000X NM
Student in an Organized Health Care Education/Training Program 390200000X TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X DO-06092 IA Primary

Addresses

Primary practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-6772

Other practice location 1

1400 W 22nd St
Sioux Falls, SD 57105-1554
Phone (605) 357-1386

Other practice location 2

1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-2321

Other practice location 3

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220713003404 IA Practitioner - Pathology 1456645811 Reassigns benefits to 1 organization
I20221230000141 IL Practitioner - Pathology 1456645811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

202 Picard St
Alpha, IL 61413-5023
Phone (309) 629-4601

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

855 Illini Dr
Silvis, IL 61282-2904

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-06092IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Anatomic Pathology & Clinical Pathology CurrentSince Jul 11, 2022 Accepting new patients
Genesis Health System Current Accepting new patients
Genesis Health System CurrentSince Jul 11, 2022 Accepting new patients

Locations

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

619 5th St
Durant, IA 52747
Phone (563) 785-4487

202 Picard St
Alpha, IL 61413
Phone (309) 629-4601

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.

Hospital & facility affiliations 5

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1538514138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-6772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051554",
            "country_code": "US",
            "telephone_number": "605-357-1386",
            "fax_number": "605-357-1548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-2321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775555302",
            "country_code": "US",
            "telephone_number": "409-772-2870",
            "fax_number": "409-747-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "ARWYN",
        "middle_name": "GRACE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SD",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "DO-06092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.