Individual provider Active NPI

Kristin Cunningham

  • Family Nurse Practitioner
  • Burlington, NC
National Provider Identifier
1942749155
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009313 Issued in NC
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

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170530000487 NC Practitioner - Nurse Practitioner 3476820291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
266413NCMDRegistered Nurse
APRN11007574FLMDFamily Nurse Practitioner
A160019IAMDFamily Nurse Practitioner
64151IDMDFamily 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

Verify at the official NPI Registry.