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ETHAN BRENT CUNNINGHAM FNP-C
NPI 1083013577
Nurse Practitioner - Primary Care in Ada, MI

Active since August 20, 2014PECOS Enrolled
523 EDGEWORTHE DR SE, ADA, MI 49301(616) 745-8097 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2026, Sep 2, 2025, Sep 5, 2024 (3 updates tracked since 2024).

About Ethan Brent Cunningham Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN BRENT CUNNINGHAM FNP-C (NPI 1083013577) is an individual primary care provider in Ada, Michigan, licensed in Michigan (4704328016) and active in the NPI registry since August 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1083013577
Entity TypeIndividualMale
Primary Taxonomy363LP2300X
Provider Legal NameETHAN BRENT CUNNINGHAMCredential: FNP-C
Location Address523 EDGEWORTHE DR SEAda, MI 49301-7809
Mailing Address523 Edgeworthe Dr SeAda, MI 49301-7809 · (616) 745-8097
Phone(616) 745-8097
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 20, 2014
Last NPPES UpdateMay 13, 20263 updates tracked since enumeration
NPPES CertifiedMay 13, 2026
✔ NPI 1083013577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in MI · 4704328016
523 EDGEWORTHE DR SE, Ada, MI 49301
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Brent Cunningham Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870079155
PECOS Enrollment IDI20260107002555
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Cunningham's NPI number?

The NPI number for Ethan Cunningham is 1083013577. It was assigned to this individual provider in the NPPES registry on August 20, 2014.

Where is Ethan Cunningham located?

Ethan Cunningham practices at 523 Edgeworthe Dr SE, Ada, MI 49301. The listed phone number is (616) 745-8097.

What is Ethan Cunningham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Ethan Cunningham enrolled in Medicare?

Yes. Ethan Cunningham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Cunningham was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.