Individual provider Active NPI

Lynn D Kunkel, CNP

  • Obstetrics & Gynecology Physician
  • Austell, GA
National Provider Identifier
1477543320
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
RN089519 Issued in GA
Practice address
1700 Hospital South Dr
Suite 500
Austell, GA 30106-6810
Phone
(770) 941-7717
Fax
(770) 948-9729
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X RN089519 GA Primary

Addresses

Primary practice location

1700 Hospital South Dr
Suite 500
Austell, GA 30106-6810

Mailing address

1700 Hospital South Dr
Suite 500
Austell, GA 30106-6810
Phone (770) 941-7717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080429000285 GA Practitioner - Nurse Practitioner 2860570017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1700 Hospital S Dr
Austell, GA 30106-8159

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2011 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2011 Accepting new patients
South Cobb OB/GYN, P. C. Obstetrics & Gynecology Past Accepting new patients

Locations

1700 Hospital South Dr
Ste 502
Austell, GA 30106
Phone (770) 739-9555

1700 Hospital South Dr
Ste 500
Austell, GA 30106
Phone (770) 941-7717

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • Direct secure messaging: lkunkel9356@directwellstar.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1477543320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 500",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066810",
            "telephone_number": "770-941-7717",
            "fax_number": "770-948-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 500",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066810",
            "telephone_number": "770-941-7717",
            "fax_number": "770-948-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "LYNN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN089519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.