Organization Active NPI

Paul Shannon Cunningham

  • Ophthalmology Physician
  • Clinton, MD
National Provider Identifier
1609942945
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PAUL SHANNON CUNNINGHAM
Practice address
9131 Piscataway Road
#150
Clinton, MD 20735
Phone
(301) 868-8300
Fax
(301) 868-7250
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul Shannon Cunningham, MDNPI 1093881344
Title
Opthalmoogist
Phone
(301) 868-8300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

9131 Piscataway Road
#150
Clinton, MD 20735

Mailing address

9131 Piscataway Road
#150
Clinton, MD 20735
Phone (301) 868-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050920001124 DC Part B Supplier - Clinic/Group Practice 2264466143 Receives reassigned benefits from 4 practitioners
Practice locations: Clinton, MD

National Provider Directory

National Provider Directory

Locations

9131 Piscataway Rd
Ste 650
Clinton, MD 20735

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609942945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY ROAD",
            "address_2": "#150",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "20735",
            "telephone_number": "301-868-8300",
            "fax_number": "301-868-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY ROAD",
            "address_2": "#150",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "20735",
            "telephone_number": "301-868-8300",
            "fax_number": "301-868-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL SHANNON CUNNINGHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "OPTHALMOOGIST",
        "authorized_official_telephone_number": "301-868-8300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.