Individual provider Active NPI

Mara Lynn Cunningham, D.O.

  • Family Medicine Physician
  • Coppell, TX
National Provider Identifier
1629280078
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M8613 Issued in TX
Practice address
2999 Olympus Blvd Ste 300
Coppell, TX 75019-6340
Phone
(214) 645-6800
NPI assigned
May 5, 2007
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M8613 TX Primary

Addresses

Primary practice location

2999 Olympus Blvd Ste 300
Coppell, TX 75019-6340

Mailing address

2999 Olympus Blvd Ste 300
Coppell, TX 75019-1205
Phone (469) 647-4250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090527000230 TX Practitioner - Family Practice 0547319386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3450 W Camp Wisdom Rd
Suite 100
Dallas, TX 75237-2504
Phone (214) 214-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 15, 2018 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Sep 15, 2018 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

2999 Olympus Blvd
Ste 300
Coppell, TX 75019
Phone (214) 645-6800

3450 W Camp Wisdom Rd
Ste 100
Dallas, TX 75237
Phone (214) 214-5800

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8194 Walnut Hill Ln
Ste 100
Dallas, TX 75231
Phone (214) 645-3900

2210 N State Highway 360
Grand Prairie, TX 75050
Phone (972) 606-8300

2740 N State Highway 360
Ste 100
Grand Prairie, TX 75050
Phone 9726068300 ext. 266

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1629280078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 OLYMPUS BLVD STE 300",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750191205",
            "telephone_number": "469-647-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 OLYMPUS BLVD STE 300",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750196340",
            "telephone_number": "214-645-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MARA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-05",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M8613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

Verify at the official NPI Registry.