Active NPI
Sara Cunningham, RD, CDE
- Registered Dietitian
- Washington, MO
National Provider Identifier
1568623833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2001012329
- Practice address
- 851 E 5TH St
Washington, MO 63090-3135 - Phone
- (636) 239-8000
- NPI assigned
- Jun 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2001012329 | MO | Primary |
Addresses
Primary practice location
851 E 5TH St
Washington, MO 63090-3135
Mailing address
851 E 5TH St
Washington, MO 63090-3135
Phone (636) 239-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 355270604 | Medicaid | MO |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481760000000",
"number": "1568623833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "851 E 5TH ST",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630903135",
"telephone_number": "636-239-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "851 E 5TH ST",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630903135",
"telephone_number": "636-239-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "SARA",
"credential": "RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-19",
"last_updated": "2016-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2001012329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "355270604",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.