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General NPI Number Information
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NPI Number | 1629929682
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Entity Type | Organization
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Legal Business Name | SPRINGFIELD NEUROLOGICAL INSTITUTE, L.L.C.
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 3801 S NATIONAL AVE STE 130
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City | SPRINGFIELD
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State | MO
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Zip | 65807-5210
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Country | US
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Telephone | 417-885-3888
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Fax | 417-881-7216
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Provider Business Mailing Address
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Address Line | 1414 E PRIMROSE ST STE 100
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4283
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Country | US
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Telephone | 417-882-1207
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Fax | 417-881-7268
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Authorized Official
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Title or Position | NEUROSURGEON
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Name | EDWIN J. CUNNINGHAM III
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Credential | MD
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Telephone | 417-885-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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