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Ethan Brent Cunningham , FNP-C

Nurse Practitioner - Primary Care β€’ Ada, MI

Active NPI 1083013577 Individual Practitioner Male Practitioner
Practice location in NPPES

523 Edgeworthe Dr Se
Ada, MI 493017809

Call 6167458097 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

523 Edgeworthe Dr Se

Ada, MI 493017809

Telephone 6167458097

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2024

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

Years since graduation

2 years (graduated 2024)

CMS Doctors and Clinicians data list 2024 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

May accept Medicare assignment

CMS data show this clinician may accept Medicare assignment. Clinicians who do not always accept assignment can decide case by case.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Ethan Cunningham has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Ethan Cunningham as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Ada and Michigan

1 active clinicians are listed under Nurse Practitioner - Primary Care with a practice address in Ada, MI (426 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-05-13
Nurse Practitioner - Primary Care Primary Specialty

NUCC Taxonomy Code: 363LP2300X

License # reported to NPPES MI 4704328016
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - NURSE PRACTITIONER

Medicare Enrollment ID

I20260107002555

Enrollment State Jurisdiction

MI

PECOS Control ID

3870079155

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ‘€
Provider Name / Credentials Updated September 02, 2025

Recorded as ETHAN CUNNINGHAM, FNP-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2025

Nurse Practitioner (license number reported to NPPES: MI 4704328016)

πŸ“
Updated Practice Location September 05, 2024

Registered at 523 EDGEWORTHE DR SE, ADA, MI 493017809 (Tel: 6167458097)

πŸ“
Updated Business Mailing Address September 05, 2024

Registered at 523 EDGEWORTHE DR SE, ADA, MI 493017809 (Tel: 6167458097)

βœ…
NPI Profile Active September 01, 2015

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 01, 2015

Registered at 1404 SIGSBEE ST SE, GRAND RAPIDS, MI 495062731 (Tel: 6167458097)

πŸ“
Business Mailing Address (Initial Record) September 01, 2015

Registered at 1404 SIGSBEE ST SE, GRAND RAPIDS, MI 495062731 (Tel: 6167458097)

πŸ‘€
Provider Name / Credentials (Initial Record) September 01, 2015

Recorded as ETHAN CUNNINGHAM, ATC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 01, 2015

Specialist/Technologist (license number reported to NPPES: MI 2601000325)

🟒
Initial NPI Registration & Enumeration August 20, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1083013577
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 20, 2014
Last Update: May 13, 2026
Sole Proprietor: Yes

Mailing Address

523 Edgeworthe Dr Se

Ada, MI 493017809

Phone: 6167458097

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.