DR. JASON CUNNINGHAM DO NPI 1811990237

NPI Information

NPI: 1811990237
Provider Name: DR. JASON CUNNINGHAM, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
6800 PALM AVE
SUITE C
SEBASTOPOL, CA
ZIP 95472
Phone: (707) 824-9999
Get Directions

DR. Jason Cunningham, DO is a family medicine in Sebastopol, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Jason Cunningham, DO NPI is 1811990237. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6800 PALM AVE
SUITE C
SEBASTOPOL, CA
ZIP 95472-269
Phone: (707) 824-9999
Fax: (707) 824-2853

The NPI 1811990237 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/31/2005 and was last updated on 6/25/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		20A8284	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1598768962	MEDICAID	CALIFORNIA
2	1356344758	MEDICAID	CALIFORNIA
3	1538334065	MEDICAID	CALIFORNIA
4	051140	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA
5	020A82841	MEDICARE PIN
6	ZZZ23666Z	OTHER	CALIFORNIA	BLUE SHIELD PIN
7	H98681	MEDICARE UPIN
8	00AX82840	MEDICAID	CALIFORNIA
9	237310613	OTHER		TIN
10	551803	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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