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MRS. DONNA CUNNINGHAM APRN,BC,FNP
NPI 1164423810
Nurse Practitioner - Family in Chillicothe, OH

Active since August 03, 2005PECOS EnrolledAccepts Medicare Assignment
90.4/100
CMS Quality Rating
4439 STATE RT 159, SUITE 260, CHILLICOTHE, OH 45601(740) 779-7460(740) 779-7463 Get Directions Write a Review

NPPES record last updated: September 12, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Donna Cunningham Aprn,bc,fnp NPPES

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

MRS. DONNA CUNNINGHAM APRN,BC,FNP (NPI 1164423810) is an individual family provider in Chillicothe, Ohio, licensed in Ohio (RN-266732) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with Ohio Valley Surgical Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1164423810
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. DONNA CUNNINGHAMCredential: APRN,BC,FNP
Location Address4439 STATE RT 159, SUITE 260Chillicothe, OH 45601
Mailing Address110 Fairway DrWilmington, OH 45177-8756 · (937) 383-3870 · Fax (937) 383-9875
Phone(740) 779-7460
Fax(740) 779-7463
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateAugust 3, 2005
Last NPPES UpdateSeptember 12, 2012
✔ NPI 1164423810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · RN-266732
4439 STATE RT 159, Chillicothe, OH 45601
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Other Identifiers 3

Medicare PINH043240OH
Medicare UPINP60283OH
Medicaid2314945OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Donna Cunningham Aprn,bc,fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183525801
PECOS Enrollment IDI20040115001184
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
861 services172 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
141 services95 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
83 services83 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
63 services21 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ohio Valley Surgical Hospital

Acute Care Hospitals · Springfield, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number360355
Location100 West Main StreetSpringfield, OH 45502 · Clark County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45601 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Improvement Activities40
Cost60.81

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 Donna Cunningham's NPI number?

The NPI number for Donna Cunningham is 1164423810. It was assigned to this individual provider in the NPPES registry on August 3, 2005.

Where is Donna Cunningham located?

Donna Cunningham practices at 4439 State Rt 159 Suite 260, Chillicothe, OH 45601. The listed phone number is (740) 779-7460.

What is Donna Cunningham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Donna Cunningham enrolled in Medicare?

Yes. Donna Cunningham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Donna Cunningham accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and MedMutual and 2 other insurers list Donna Cunningham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Donna Cunningham affiliated with any hospitals?

According to CMS data, Donna Cunningham is affiliated with Ohio Valley Surgical Hospital.

When was this NPI record last updated?

The NPPES record for Donna Cunningham was last updated on September 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.