Active NPI
Kendra Celeste Cunningham, LPN, MA
- Licensed Practical Nurse
- Augusta, GA
National Provider Identifier
1861697187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 077864
- Practice address
- 1243 Pine St
Augusta, GA 30901-3334 - Phone
- (678) 887-8706
- NPI assigned
- Jun 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 077864 | GA | Primary |
Addresses
Primary practice location
1243 Pine St
Augusta, GA 30901-3334
Mailing address
512 Weatherly Dr
Stone Mountain, GA 30083
Phone (678) 887-8706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077864 | GA | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diamond and Pearls Affiliates L.L.C. | Home Health | Current | Accepting new patients |
Organizations & group practices 1
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": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1861697187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 WEATHERLY DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "30083",
"telephone_number": "678-887-8706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1243 PINE ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309013334",
"telephone_number": "678-887-8706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "KENDRA",
"middle_name": "CELESTE",
"name_prefix": "Prof.",
"credential": "LPN, MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-18",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "GA",
"license": "077864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.