Kellie Lyn Dunkin, MSN NP

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

28140084A Issued in IN

Practice address

451 S Park Ridge Rd
Suite 101
Bloomington, IN 47401-8589

Phone

(812) 331-8282

Fax

(812) 331-8283

NPI assigned

Sep 25, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1285060947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 S PARK RIDGE RD",
            "address_2": "SUITE 101",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018589",
            "telephone_number": "812-331-8282",
            "fax_number": "812-331-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 S PARK RIDGE RD",
            "address_2": "SUITE 101",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018589",
            "telephone_number": "812-331-8282",
            "fax_number": "812-331-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKIN",
        "first_name": "KELLIE",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "MSN NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "28140084A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa M Duncan, LLC
• Michelle Dianne Duncan, FNP
• Michael Tim Dunfee, M.D.
• Dungarvin Indiana, LLC
• Patrick Lee Dunigan, D.D.S.
• Allen W Dunn, M.D.
• David A Dunn, D.O.
• Maxwell Dunn, RBT
• Elaine D Dupler, MD
• James F Dupler, MD

• Primary Care Clinic/Center in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.