Individual provider Active NPI

Steven Craig Kunkel Jr., PT, OCS, COMT

  • Physical Therapist
  • Elkton, MD
National Provider Identifier
1467530865
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20117 Issued in MD
Practice address
9 South Bridge Street Plaza
Elkton, MD 21921-8707
Phone
(410) 392-0800
Fax
(410) 392-0815
NPI assigned
Nov 2, 2006
Last updated
Nov 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20117 MD Primary

Addresses

Primary practice location

9 South Bridge Street Plaza
Elkton, MD 21921-8707

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000216 MD Practitioner - Physical Therapist in Private Practice 4385736347 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Rehab at Home, Inc.Group PAC ID 4486833274, 17 clinicians

Practice addresses (Care Compare)

227 Bank St
Chesapeake City, MD 21915-1016
Phone (410) 392-2731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20117MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince May 5, 2014 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince May 5, 2014 Accepting new patients
Total Rehab at Home, Inc. Physical Therapist CurrentSince Mar 1, 2010 Accepting new patients
Ati Holdings, LLC Past Accepting new patients
Ati Holdings, LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

139 E High St
Elkton, MD 21921
Phone (410) 392-2731

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1467530865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SOUTH BRIDGE STREET PLAZA",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219218707",
            "telephone_number": "410-392-0800",
            "fax_number": "410-392-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "STEVEN",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT, OCS, COMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.