Active NPI
Kristin Cunningham
- Family Nurse Practitioner
- Burlington, NC
National Provider Identifier
1942749155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5009313
- Practice address
- 2905 Crouse LN
Burlington, NC 27215-8833 - Phone
- (336) 538-2494
- Fax
- (336) 538-2497
- NPI assigned
- Feb 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 266413 | NC | |
| Family Nurse Practitioner | 363LF0000X | 240168 | AZ | |
| Family Nurse Practitioner | 363LF0000X | 64151 | ID | |
| Family Nurse Practitioner | 363LF0000X | A160019 | IA | |
| Family Nurse Practitioner | 363LF0000X | APRN11007574 | FL | |
| Family Nurse Practitioner | 363LF0000X | 266413 | NC | |
| Family Nurse Practitioner | 363LF0000X | 5009313 | NC | Primary |
Addresses
Primary practice location
2905 Crouse LN
Burlington, NC 27215-8833
Mailing address
210 Landreth CT
Durham, NC 27713-7580
Phone (301) 648-4202
Other practice location 1
8210 Renaissance Pkwy
Durham, NC 27713-6688
Phone (919) 674-2215
Other practice location 2
210 Landreth Ct
Durham, NC 27713-7580
Phone (301) 648-4202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170530000487 | NC | Practitioner - Nurse Practitioner | 3476820291 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 266413 | NC | MD | Registered Nurse |
| APRN11007574 | FL | MD | Family Nurse Practitioner |
| A160019 | IA | MD | Family Nurse Practitioner |
| 64151 | ID | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601596800000",
"number": "1942749155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 LANDRETH CT",
"city": "DURHAM",
"state": "NC",
"postal_code": "277137580",
"telephone_number": "301-648-4202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 CROUSE LN",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272158833",
"telephone_number": "336-538-2494",
"fax_number": "336-538-2497"
}
],
"practiceLocations": [
{
"address_1": "8210 Renaissance Pkwy",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277136688",
"country_code": "US",
"telephone_number": "919-674-2215",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "210 Landreth Ct",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277137580",
"country_code": "US",
"telephone_number": "301-648-4202",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-21",
"last_updated": "2020-10-02",
"certification_date": "2020-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "266413",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "240168",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "64151",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A160019",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11007574",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "266413",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5009313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.