Active NPI
Malcom Cunningham, MD
- Psychiatry Physician
- Fackler, AL
National Provider Identifier
1609922806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 45119
- Practice address
- 1696 County Road 39
Fackler, AL 35746-4909 - Phone
- (904) 687-3213
- NPI assigned
- Jan 28, 2007
- Last updated
- May 30, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 45119 | AL | Primary |
Addresses
Primary practice location
1696 County Road 39
Fackler, AL 35746-4909
Mailing address
1696 County Road 39
Fackler, AL 35746-4909
Phone (904) 687-3213
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
| License | State | Type | Specialty |
|---|---|---|---|
| 45119 | AL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cunningham Psychiatric Group | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Sherman Oaks, CA
- NPI 1144376344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1609922806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1696 COUNTY ROAD 39",
"city": "FACKLER",
"state": "AL",
"postal_code": "357464909",
"telephone_number": "904-687-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1696 COUNTY ROAD 39",
"city": "FACKLER",
"state": "AL",
"postal_code": "357464909",
"telephone_number": "904-687-3213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "MALCOM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-28",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AL",
"license": "45119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.