Individual provider Active NPI

Chelsey Lynn Cunningham

  • Medical Physician Assistant
  • Jacksonville, NC
National Provider Identifier
1801588736
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
317 Western Blvd
Jacksonville, NC 28546-6338
Phone
(910) 577-2345
NPI assigned
May 22, 2023
Last updated
May 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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 NU Primary

Addresses

Primary practice location

317 Western Blvd
Jacksonville, NC 28546-6338

Mailing address

4293 Sustain Cir
Franklinton, NC 27525-9506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230801004328 NC Practitioner - Physician Assistant 8921469313 Reassigns benefits to 1 organization
I20251118000878 CA Practitioner - Physician Assistant 8921469313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palomar Emergency Physicians, IncGroup PAC ID 9830593730, 71 clinicians

Practice addresses (Care Compare)

15615 Pomerado Rd
Poway, CA 92064-2405
Phone (310) 379-2134

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Palomar Emergency Physicians, Inc CurrentSince Nov 4, 2025 Accepting new patients
Team Physicians of Southern California Medical Group, Inc. CurrentSince Dec 30, 2025 Accepting new patients

Locations

4002 Vista Way
Oceanside, CA 92056
Phone (760) 724-8411

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1801588736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4293 SUSTAIN CIR",
            "city": "FRANKLINTON",
            "state": "NC",
            "postal_code": "275259506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-577-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "CHELSEY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.