Lisa A Cunningham, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2012035124 Issued in MO

Practice address

1605 Martin Springs Dr
Ste 250
Rolla, MO 65401-2931

Phone

(573) 458-6363

Fax

(573) 458-6765

NPI assigned

Oct 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pcrmc Medical Group, Inc

  • Clinic/Center
  • Rolla, MO
  • NPI 1124237227
  Medicare reassignment Care Compare group NPD
• Phelps County Regional Medical Center

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phelps County Regional Medical Center

  • Rural Health Clinic/Center
  • Salem, MO
  • NPI 1194077701

  Hospital

  Care Compare affiliation
• Phelps County Regional Medical Center

  • Rehabilitation Hospital Unit
  • Rolla, MO
  • NPI 1346287455
  Care Compare affiliation
• Phelps County Regional Medical Center

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Care Compare affiliation

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1790037950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "STE 250",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012931",
            "telephone_number": "573-458-6363",
            "fax_number": "573-458-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012035124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790037950",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01116108",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Rene Critz, RN
• Andrea Crossley, MSN,APRN,CPNP-PC
• Albert L Crump, MSSW, DSW, LCSW
• Vanesa Culwell
• Karrie A. Cunningham, MD
• Dabci Market Share, LLC
• Jeannie Gloria Dake
• Jill Shannon Dalton
• Daniel B Bruin DMD LLC
• Gina Marie Daniels, P.T.

• Family Nurse Practitioner in Rolla, MO
• Providers in Rolla, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.