Individual provider Active NPI

Patricia Anne Cunningham, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1619413879
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP016983 Issued in PA
Practice address
230 W Washington SQ FL 4
Philadelphia, PA 19106-3500
Phone
(800) 789-7366
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP016983 PA
Nurse Practitioner 363L00000X SP016983 PA Primary

Addresses

Primary practice location

230 W Washington SQ FL 4
Philadelphia, PA 19106-3500

Mailing address

230 W Washington SQ FL 4
Philadelphia, PA 19106-3500
Phone (800) 789-7366

Other practice location 1

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 994-2511 ext. 5492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP016983PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Nurse Practitioner CurrentSince Dec 1, 2019 Accepting new patients
Penn Medicine-Pma Current Accepting new patients
University of Penn-Medical Group CurrentSince Apr 17, 2017 Accepting new patients
University of Penn - Medical Group CurrentSince Apr 17, 2017 Accepting new patients
Acts Signature Community Services, Inc. Current Accepting new patients
Acts Signature Community Services, Inc. CurrentSince Oct 12, 2020 Accepting new patients
Acts Signature Community Services, Inc. CurrentSince Oct 12, 2020 Accepting new patients
Penn Medicine-Pma CurrentSince Jul 25, 2022 Accepting new patients

Locations

150 Monument Rd
Ste 400
Bala Cynwyd, PA 19004
Phone (610) 747-3470

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

420 Delaware Dr
Ft Washington, PA 19034
Phone (215) 661-8330

2510 W Township Line Rd
Havertown, PA 19083
Phone (484) 450-4500

2 W Baltimore Ave
Media, PA 19063
Phone (484) 227-0900

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

230 W Washington Sq
Fl 4
Philadelphia, PA 19106
Phone (215) 829-3561

Interoperability endpoints

  • FHIR API: https://ssproxy.pennhealth.com/PRD-FHIR/api/FHIR/R4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619413879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W WASHINGTON SQ FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063500",
            "telephone_number": "800-789-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W WASHINGTON SQ FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063500",
            "telephone_number": "800-789-7366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Kirkwood Hwy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198054917",
            "country_code": "US",
            "telephone_number": "302-994-2511 x5492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP016983",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.