Jack Cunningham

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

677 Issued in HI

Practice address

1221 Kilauea Ave
Hilo, HI 96720-4271

Phone

(808) 607-0117

NPI assigned

Dec 1, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1588039648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-2662 PAHOA VILLAGE RD # 306-105",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967787730",
            "telephone_number": "510-695-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204271",
            "telephone_number": "808-607-0117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Crow Canyon Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945831344",
            "country_code": "US",
            "telephone_number": "510-999-4410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-01",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crown Vision Creation Group Int'L Inc
• Shelley Cua-Enriquez
• Pamela Cuarisma
• Briauncey Kahunani Kuuipolani Cuffe-Prudencio
• Phyllis Anne Cullen, M.D.
• Heather Afton Curry
• Curtis W Lee, M.D., Inc.
• Nile Curtis
• Cynthia Fata, LMHC, Counseling and Consulting, LLC
• Joseph A D'Angelo, M.D.

• Behavior Analyst in Hilo, HI
• Providers in Hilo, HI by specialty
• Behavior Analyst in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.