Individual provider Active NPI

Stephen G Cunningham, MD

  • Psychiatry Physician
  • Virginia Beach, VA
National Provider Identifier
1780855114
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101242553 Issued in VA
Practice address
240 Business Park Dr Ste 100
Suite G
Virginia Beach, VA 23462-6521
Phone
(757) 497-3670
Fax
(757) 499-1947
NPI assigned
Mar 13, 2008
Last updated
Sep 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101242553 VA Primary

Addresses

Primary practice location

240 Business Park Dr Ste 100
Suite G
Virginia Beach, VA 23462-6521

Mailing address

240 Business Park Dr Ste 100
Suite G
Virginia Beach, VA 23462-6521
Phone (757) 497-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090715000723 VA Practitioner - Psychiatry 9931251329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Eastern Virginia Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Psychotherapy ServicesGroup PAC ID 9335128305, 10 clinicians

Practice addresses (Care Compare)

260 Grayson Rd
Suite 100
Virginia Beach, VA 23462-4345
Phone 7574973670230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101242553VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Psychotherapy Services CurrentSince Jul 24, 2022 Accepting new patients
First Hospital Corporation of Virginia Beach CurrentSince Apr 24, 2023 Accepting new patients
Tidewater Psychotherapy Services Psychiatry CurrentSince Jul 19, 2010 Accepting new patients
Hampton Roads Behavioral Health,PC PastSince Dec 1, 1991 Accepting new patients

Locations

1100 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 463-5240

260 Grayson Rd
Ste 100
Virginia Beach, VA 23462
Phone (757) 497-3670

Organizations & group practices 4

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": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1780855114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 BUSINESS PARK DR STE 100",
            "address_2": "SUITE G",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626521",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 BUSINESS PARK DR STE 100",
            "address_2": "SUITE G",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626521",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "STEPHEN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101242553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.