Individual provider Active NPI

Katrina Pajarillo Cunningham, NP

  • Acute Care Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1760181705
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN2302489 Issued in MA
Practice address
110 Long Pond Rd Ste 212
Plymouth, MA 02360-2642
Phone
(508) 746-7272
NPI assigned
Feb 28, 2023
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2302489 MA Primary
Registered Nurse 163W00000X RN2302489 MA

Addresses

Primary practice location

110 Long Pond Rd Ste 212
Plymouth, MA 02360-2642

Mailing address

110 Long Pond Rd Ste 212
Plymouth, MA 02360-2642
Phone (508) 746-7272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241002000364 MA Practitioner - Nurse Practitioner 5092246025 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Carver Primary Care, P.C. CurrentSince Sep 23, 2024 Accepting new patients
Plymouth Carver Primary Care PastSince Sep 1, 2024 Accepting new patients

Locations

110 Long Pond Rd
Ste 212
Plymouth, MA 02360
Phone (508) 746-0565

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1760181705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD STE 212",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642",
            "telephone_number": "508-746-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD STE 212",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642",
            "telephone_number": "508-746-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KATRINA",
        "middle_name": "PAJARILLO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2302489",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2302489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.