Kellie Kunkel

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704278856 Issued in MI

Practice address

18606 Cedar Dr E
Fort Myers, FL 33967-3490

Phone

(586) 863-7751

NPI assigned

Nov 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Wa Foote Memorial Hospital, Inc

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
  • NPI 1598776718

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Chelsea Community Hospital

  • Certified Registered Nurse Anesthetist
  • Chelsea, MI
  • NPI 1568542967

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Michigan Crnas Staffing LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1851666424
  Medicare reassignment NPD
• Novi Aas LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1598176919
  Medicare reassignment NPD
• West Michigan Aas LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1295149227
  Medicare reassignment NPD
• Chelsea Community Hospital

  • Urgent Care Clinic/Center
  • Chelsea, MI
  • NPI 1033778733
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

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

• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1448064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1700250271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4963",
            "fax_number": "517-789-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18606 CEDAR DR E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339673490",
            "telephone_number": "586-863-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-21",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9374213",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704278856",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704278856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkunkel19707@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Soltandjamal Kuliyeva
• Manisha Kumar
• Seemal Sanjana Kumar
• Vinod Kumar, MD
• Whitney Kummer, OTR/L
• Nardria R Kunkel, MSW
• Otto J Kunst, MD
• Kristen A Kupeyan, MD, MHSA
• Robert Eliot Kupsaw, M.D.
• Laura Theophilia Kuras, MLS, MT

• Certified Registered Nurse Anesthetist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.