Individual provider Active NPI

John A Cunningham, DPM

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
National Provider Identifier
1841237864
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3192 Issued in FL
Practice address
3829 Paddington PL
St Augustine, FL 32092-3660
Phone
(904) 940-6049
Fax
(904) 940-4811
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3192 FL Primary

Addresses

Primary practice location

3829 Paddington PL
St Augustine, FL 32092-3660

Mailing address

3829 Paddington PL
St Augustine, FL 32092-3660
Phone (904) 940-6049

Other identifiers 2

IdentifierTypeStateIssuer
340529000MedicaidFL
P00260023OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050901000021 FL Practitioner - Podiatry 0244268787 Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3192FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Park Podiatric Foot and Ankle Clinic, Inc Past Accepting new patients
Marc a. Brenner Foot & Ankle Surgery Past Accepting new patients
Brooklyn Footcare, P.C. PastSince Oct 21, 2014 Accepting new patients
Health Park Foot & Ankle Associates Inc Past Accepting new patients

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1841237864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 PADDINGTON PL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923660",
            "telephone_number": "904-940-6049",
            "fax_number": "904-940-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 PADDINGTON PL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923660",
            "telephone_number": "904-940-6049",
            "fax_number": "904-940-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340529000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00260023",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.