Maria Elizabeth Cunningham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2185 Issued in KY

Practice address

2333 Ring Rd
Elizabethtown, KY 42701-9162

Phone

(270) 737-4503

Fax

(270) 769-1978

NPI assigned

Nov 2, 2016

Last updated

Nov 5, 2018By the provider in NPPES

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 names 1

• Maria Elizabeth Kelly Former name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Kentucky Dermatology, PSC

  • Dermatology Physician
  • Madisonville, KY
  • NPI 1275580888

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1841742269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019162",
            "telephone_number": "270-737-4503",
            "fax_number": "270-769-1978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Medical Park Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Campbellsville",
            "state": "KY",
            "postal_code": "427187639",
            "country_code": "US",
            "telephone_number": "270-737-4503",
            "fax_number": "270-769-1978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Brandenburg",
            "state": "KY",
            "postal_code": "401089784",
            "country_code": "US",
            "telephone_number": "270-737-4503",
            "fax_number": "270-769-1978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MARIA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "KELLY",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.