Individual provider Active NPI

Thomas Keith Cunningham, FNP-C

  • Nurse Practitioner
  • Lincolnton, GA
National Provider Identifier
1861662470
Registry record updated Jul 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN115548 Issued in GA
Practice address
611 N Washington St
Lincolnton, GA 30817-6037
Phone
(706) 359-4215
Fax
(706) 359-1662
NPI assigned
Mar 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN115548 GA Primary

Addresses

Primary practice location

611 N Washington St
Lincolnton, GA 30817-6037

Mailing address

PO Box 568
Washington, GA 30673-0568
Phone (706) 359-4215

Other identifiers 1

IdentifierTypeStateIssuer
000922567FMedicaidGA

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent MD Healthcare Services, P.C. 20 clinicians

Practice addresses (Care Compare)

1008 E Robert Toombs Ave
Washington, GA 30673-2089
Phone (706) 678-1633

Hospital & facility affiliations

  • Wills Memorial Hospital Hospital, Washington, GA, CCN 111325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000860 GA Practitioner - Nurse Practitioner 4082511084 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent MD Healthcare Services, P.C. Current Accepting new patients
Urgent MD Healthcare Services, P.C. CurrentSince Apr 1, 2024 Accepting new patients
Southcare Medical Center Past Accepting new patients
Ar Medical LLC Past Accepting new patients

Locations

3686 Wheeler Rd
Augusta, GA 30909
Phone (706) 364-6471

1008 E Robert Toombs Ave
Washington, GA 30673
Phone (706) 678-1633

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469318400000",
    "number": "1861662470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "WASHINGTON",
            "state": "GA",
            "postal_code": "306730568",
            "telephone_number": "706-359-4215",
            "fax_number": "706-359-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N WASHINGTON ST",
            "city": "LINCOLNTON",
            "state": "GA",
            "postal_code": "308176037",
            "telephone_number": "706-359-4215",
            "fax_number": "706-359-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "THOMAS",
        "middle_name": "KEITH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2016-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN115548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000922567F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnton, GA

Sources for this page

Verify at the official NPI Registry.