Brian Harold Cunningham, M.D.
Individual provider Active NPI Emergency Medicine Physician · Waterloo, IA
NPI 1619009537 · NPPES record last updated Apr 21, 2009
Key facts
- NPI
- 1619009537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 37170 (IA)
- Practice address
- 1825 Logan Ave
Emergency Department
Waterloo, IA 50703-1916 - Phone
- (319) 235-3697
- Fax
- (319) 235-3844
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of Nebraska College of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nebraska Orthopaedic Hospital LLC
Practice addresses (Care Compare)
2727 S 144TH St
150 Emergency Department
Omaha, NE 68144-5225
Phone (402) 609-1500
Hospital & facility affiliations
- CHI Health St. Elizabeth
- Nebraska Orthopaedic Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100920001189 | NE | Practitioner - Emergency Medicine | 9638262033 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEP 5009 | NE | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VWB LLC | Current |
Accepting new patients | |
| Alegent Creighton Clinic | Current |
Accepting new patients | |
| Premier Urgent Care/Family Care of Nebraska LLC | Current |
Accepting new patients | |
| North Platte Nebraska Physician Group LLC | Emergency Medicine | Past | Accepting new patients |
| New Century Physicians of Iowa PC | Emergency Medicine | Past | Accepting new patients |
| Alegent Creighton Clinic | Past | Accepting new patients |
Locations
800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000
2771 Solution Ctr
Chicago, IL 60677
555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000
16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500
7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880
4004 N 132nd St
Ste 101
Omaha, NE 68164
Phone (402) 302-2273
16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920
11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | TEP 5009 | NE | |
| Emergency Medicine Physician | 207P00000X | 37170 | IA | Yes |
Addresses
Primary practice location
1825 Logan Ave
Emergency Department
Waterloo, IA 50703-1916
Mailing address
1825 Logan Ave
Emergency Department
Waterloo, IA 50703-1916
Phone (319) 235-3697
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CP7479 | Other | RAILROAD MEDICARE GROUP NUMBER | |
| 0798371 | Medicaid | IA | |
| 70036 | Other | IA | WELLMARK BC/BS IOWA |
| P00465295 | Other | RAILROAD MEDICARE PTAN |
Other providers in Waterloo, IA
- Alexander Crum
- Heather E. Cue
- Rhonda Ann Cue
- Dilan J Cummings
- Desiree K Cunningham-Loggins
- Darron Paul Cutler
- Levi Kenneth Dahle
- Bethany Daly
- Jodi Danielsen
- Tarek Michel Daoud
All providers in Waterloo, IA · Emergency Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.