Individual provider Active NPI

Stephanie Marie Cunningham, PA-C

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1659623593
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006469 Issued in MI
Practice address
4081 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-2170
Phone
(616) 957-3500
Fax
(616) 957-3501
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601006469 MI Primary

Addresses

Primary practice location

4081 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-2170

Mailing address

4081 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-2170
Phone (616) 957-3500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address scunningham88974@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140102001135 MI Practitioner - Physician Assistant 5698903359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

2332 Alpine Ave NW
Corewell Health Medical Group West
Grand Rapids, MI 49544-1955
Phone (616) 267-8950

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

6105 Wilson Ave SW
Wyoming, MI 49418-9714

6105 Wilson Ave SW FL
2 Corewell Health Medical Group West
Wyoming, MI 49418-9714
Phone (616) 267-8950

80 68TH St SE
Grand Rapids, MI 49548-6980

80 68TH St SE FL
1 Corewell Health Medical Group West
Grand Rapids, MI 49548-6980
Phone (616) 267-8950

8333 Felch St
Zeeland, MI 49464-2608

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601006469MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group Physician Assistant CurrentSince Dec 9, 2013 Accepting new patients
Spectrum Health Hospitals CurrentSince Dec 9, 2013 Accepting new patients
Spectrum Health Hospitals CurrentSince Dec 9, 2013 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2014 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2014 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4075 32nd Ave
Hudsonville, MI 49426
Phone (616) 229-9310

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

5500 Clyde Park Ave SW
Wyoming, MI 49509
Phone (616) 530-7110

Interoperability endpoints

  • Direct secure messaging: scunningham88974@epic00.corewelldirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1659623593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 CASCADE RD SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462170",
            "telephone_number": "616-957-3500",
            "fax_number": "616-957-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4081 CASCADE RD SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462170",
            "telephone_number": "616-957-3500",
            "fax_number": "616-957-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scunningham88974@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "4081 Cascade Rd SE",
            "address_2": "Suite A",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495462170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4081 Cascade Rd SE",
            "address_2": "Suite A",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495462170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.