Individual provider Active NPI

Jennifer Sue Kunkle, FNP

  • Family Nurse Practitioner
  • Troy, OH
National Provider Identifier
1407515588
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0027724 Issued in OH
Practice address
3230 N County Road 25a
Troy, OH 45373-1338
Phone
(937) 440-7040
NPI assigned
Dec 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0027724 OH Primary

Addresses

Primary practice location

3230 N County Road 25a
Troy, OH 45373-1338

Mailing address

3230 N County Road 25a
Troy, OH 45373-1338
Phone (937) 440-7040

Other practice location 1

3055 Kettering Blvd Ste 300
Moraine, OH 45439-1991
Phone (937) 299-5379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20220720003813 OH Practitioner - Nurse Practitioner 9133500234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Vitas Solutions IncGroup PAC ID 7012087166, 55 clinicians

Practice addresses (Care Compare)

3055 Kettering Blvd
Suite 320
Moraine, OH 45439-1981
Phone (937) 299-5379

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027724OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Solutions Inc Nurse Practitioner CurrentSince Dec 6, 2025 Accepting new patients
Hospice of Miami County, Inc. CurrentSince Jun 18, 2023 Accepting new patients

Locations

3055 Kettering Blvd
Ste 320
Moraine, OH 45439
Phone (937) 299-5379

3230 N County Road 25A
Troy, OH 45373
Phone (937) 335-5191

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1407515588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731338",
            "telephone_number": "937-440-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731338",
            "telephone_number": "937-440-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Kettering Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Moraine",
            "state": "OH",
            "postal_code": "454391991",
            "country_code": "US",
            "telephone_number": "937-299-5379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUNKLE",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0027724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

Verify at the official NPI Registry.