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NPI Code Detail

MEDICARE: DR. KEVIN PATRICK CUNNEELY M.D.

MEDICARE: DR. KEVIN PATRICK CUNNEELY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician5223918-1205UT
22085R0202XDiagnostic Radiology Physician21846ND
32085R0202XDiagnostic Radiology Physician42095TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
9P00404606OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24291494OTHERTNBCBS - MTI
34200337OTHERTNBCBS TN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
74155143OTHERTNBCBS
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
104155167OTHERTNBCBS

General Provider Information

NPI Number : 1356389597
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN PATRICK CUNNEELY M.D.
Provider Business Mailing Address
First Line : 3024 BUSINESS PARK CIR
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-3132
Country : US
Telephone Number : 615-851-6033
Fax Number : 615-851-2018
Provider Business Practice Location Address
First Line : 3024 BUSINESS PARK CIR
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-3132
Country : US
Telephone Number : 615-851-6033
Fax Number : 615-851-2018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 12/01/2025

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