Leighton Jerry Cunningham, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-424 Issued in ID

Practice address

107 S Kimball Ave
Suite 240
Caldwell, ID 83605-3735

Phone

(208) 454-1229

NPI assigned

Dec 4, 2008

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 4, 2008.

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1669617635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055032",
            "telephone_number": "208-454-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S KIMBALL AVE",
            "address_2": "SUITE 240",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836053735",
            "telephone_number": "208-454-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LEIGHTON",
        "middle_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Cron
• Stephanie Cross
• Tiffany Leeanna Cudmore
• Jessica Karina Cuevas
• Britany Jennifer Cunningham, PTA
• Current Physical Therapy Caldwell
• Mark Cushing, DDS
• Nichelle Daigle, PHARMD
• Michael T Daines, M.D.
• Katie E Dallas

• All providers in Caldwell, ID
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.