Polla Sue Cunningham, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME94647 Issued in FL

Practice address

1005 Mar Walt Drive
Administration
Fort Walton Beach, FL 32547-6796

Phone

(850) 863-8100

Fax

(850) 862-2303

NPI assigned

Nov 10, 2006

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bayne Jones Army Community Hospital

  • Family Medicine Physician
  • Niceville, FL
  • NPI 1831586312

  Internal Medicine

  NPD (past)
• Crestview Hospital Company LLC

  • Hospitalist Physician
  • Crestview, FL
  • NPI 1861441057

  Internal Medicine

  NPD (past)
• Emerald Coast Hospitalist Inc

  • Hospitalist Physician
  • Panama City, FL
  • NPI 1144548793
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1831260256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "ADMINISTRATION",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476796",
            "telephone_number": "850-863-8100",
            "fax_number": "850-862-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "ADMINISTRATION",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476796",
            "telephone_number": "850-863-8100",
            "fax_number": "850-862-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "POLLA",
        "middle_name": "SUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME94647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101581",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "41131",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278157300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7773615",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Cromwell
• Blair Crosby
• Gerardo Cruz, PA-C
• Christina K Culverson, MSN, FNP-BC
• John Rafael Roa Cunanan, MD
• Leigh Bayer Curtis, DMD, MPH
• Liana Cuttie
• CW Holistic Counseling LLC
• Ashley D'Amico, DNP, FNP-BC
• Jennifer Meshell Dahlberg

• Internal Medicine Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.