Individual provider Active NPI

Deanna E. Kunkel, CNP

  • Primary Care Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1700234077
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.019561 Issued in OH
Practice address
410 W 10TH Ave
843 Doan Hall
Columbus, OH 43210-1240
Phone
(614) 293-8536
Fax
(614) 293-8902
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 410981 OH
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.019561 OH Primary

Addresses

Primary practice location

410 W 10TH Ave
843 Doan Hall
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd
Suite 570
Columbus, OH 43202-1559
Phone (614) 366-8030

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
I20161006000993 OH Practitioner - Nurse Practitioner 5991093981 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
410981OHMDRegistered Nurse
APRN.CNP.019561OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Nutrition Center, Inc Current Accepting new patients
Central Ohio Nutrition Center CurrentSince Dec 1, 2017 Accepting new patients
Central Ohio Nutrition Center, Inc Past Accepting new patients

Locations

1904 Bethel Rd
Columbus, OH 43220
Phone (614) 451-1910

648 Taylor Rd
Gahanna, OH 43230
Phone (614) 864-7225

450 Alkyre Run
Ste 120
Westerville, OH 43082
Phone (614) 847-6008

Organizations & group practices 3

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1700234077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD",
            "address_2": "SUITE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-366-8030",
            "fax_number": "614-293-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "address_2": "843 DOAN HALL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8536",
            "fax_number": "614-293-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "DEANNA",
        "middle_name": "E.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "410981",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.019561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.