Individual provider Active NPI

Shani Cunningham, D.O.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1942526322
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS12051 Issued in FL
Practice address
601 E Rollins St
Florida Hospital Pediatric Hospitalists
Orlando, FL 32803-1248
Phone
(407) 975-0410
Fax
(407) 975-0411
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4185 IA
Pediatrics Physician 208000000X N4998 TX
Pediatrics Physician 208000000X OS12051 FL Primary

Addresses

Primary practice location

601 E Rollins St
Florida Hospital Pediatric Hospitalists
Orlando, FL 32803-1248

Mailing address

1801 Lee Rd Ste 165
Winter Park, FL 32789-2127
Phone (407) 975-0410

Other identifiers 2

IdentifierTypeStateIssuer
19242526322MedicaidIA
009381200MedicaidFL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130918000229 FL Practitioner - Pediatric Medicine 9133398233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS12051FLMDPediatrics Physician
4185IAMDPediatrics Physician
N4998TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Nov 28, 2016 Accepting new patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Nov 28, 2016 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1801 Lee Rd
Ste 165
Winter Park, FL 32789
Phone (407) 975-0406

Interoperability endpoints

  • Direct secure messaging: scunningham128888@adventhealth.direct-ci.com

Organizations & group practices 2

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": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1942526322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 165",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892127",
            "telephone_number": "407-975-0410",
            "fax_number": "407-975-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "address_2": "FLORIDA HOSPITAL PEDIATRIC HOSPITALISTS",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-975-0410",
            "fax_number": "407-975-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SHANI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "4185",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N4998",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS12051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19242526322",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009381200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.