Individual provider Active NPI

Addie Cunniff

  • Obstetrics & Gynecology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1821701905
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
SP026839 Issued in PA
Practice address
800 Walnut St FL 11
Philadelphia, PA 19107-5176
Phone
(215) 454-3534
NPI assigned
Jan 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X SP026839 PA Primary

Addresses

Primary practice location

800 Walnut St FL 11
Philadelphia, PA 19107-5176

Mailing address

4946 Pine St
Philadelphia, PA 19143-1613
Phone (520) 349-4085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20230126001142 PA Practitioner - Nurse Practitioner 3476924663 Reassigns benefits to 1 organization
I20241030003524 NJ Practitioner - Nurse Practitioner 3476924663 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Aug 19, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 23, 2023 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Aug 19, 2024 Accepting new patients

Locations

1865 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 427-4336

1865 Route 70 E
Ste 250
Cherry Hill, NJ 08003
Phone (856) 429-0400

110 Marter Ave
Ste 505
Moorestown, NJ 08057
Phone (856) 235-4840

800 Walnut St
Fl 11
Philadelphia, PA 19107
Phone (215) 573-8886

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1821701905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4946 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431613",
            "telephone_number": "520-349-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST FL 11",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075176",
            "telephone_number": "215-454-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNIFF",
        "first_name": "ADDIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "SP026839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.