Individual provider Active NPI

Nicholas Cunningham, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Matthews, NC
National Provider Identifier
1649928698
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5016175 Issued in NC
Practice address
10341 Ashley Farm Dr
Matthews, NC 28105-4581
Phone
(704) 244-3877
NPI assigned
Mar 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CUNN-H1829 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5016175 NC Primary

Addresses

Primary practice location

10341 Ashley Farm Dr
Matthews, NC 28105-4581

Mailing address

855 Sam Newell Rd Ste 100
Matthews, NC 28105-7593
Phone (704) 321-4940

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL . Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810001163 NC Practitioner - Nurse Practitioner 8325421241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

855 Sam Newell Rd
Suite 100
Matthews, NC 28105-7593
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5016175NCMDPsychiatric/Mental Health Nurse Practitioner
CUNN-H1829NCMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.nicholascunningham@146232.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1649928698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 SAM NEWELL RD STE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281057593",
            "telephone_number": "704-321-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10341 ASHLEY FARM DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054581",
            "telephone_number": "704-244-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "NICHOLAS",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "CUNN-H1829",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5016175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": ".",
            "affiliation": "N",
            "endpointDescription": ".",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": ".",
            "address_1": "10341 Ashley Farm Dr",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281054581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.