Shannon Kunkle, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.020100 Issued in IL

Practice address

825 W Jackson St
Morton, IL 61550-1569

Phone

(309) 291-0469

Fax

(309) 291-0467

NPI assigned

Sep 13, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.kunkle.1@30943.direct.athenahealth.com

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.

• 4 Integrated Health LLC

  • Family Nurse Practitioner
  • Morton, IL
  • NPI 1962239376
  NPD Authorized official

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

{
    "created_epoch": "1599955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1679188940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 W JACKSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501569",
            "telephone_number": "309-291-0469",
            "fax_number": "309-291-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W JACKSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501569",
            "telephone_number": "309-291-0469",
            "fax_number": "309-291-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKLE",
        "first_name": "SHANNON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-13",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Kominkiewicz, RN, IBCLC
• Nathan Krahn, LCPC
• Krueger & Associates LLC
• Dawn Krug
• Nita Kumaran, PHARMD, RPH
• Kurt L Ehling DC LLC
• Rose Lange, LCPC
• Danielle Rae Layne, APRN
• Hannah Kate Lee, RD LDN
• Jennifer Lynn Litherland, RPH

• Family Nurse Practitioner in Morton, IL
• Providers in Morton, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.