MR. KRISTIAN JAMES KUNICKY (NPI# 1528096237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528096237 |
| Entity Type | Individual |
| Full Name | MR. KRISTIAN JAMES KUNICKY |
| Credential | PC |
| Practice Address |
4924 Campbell Blvd Suite 130 Nottingham MD 21236-5908 |
| Mailing Address |
Po Box 64664 Baltimore MD 21264-4664 |
| Practice Telephone | 4434422080 |
| Practice Fax Number | 4434422089 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2014-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C03786 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 25MP00101100 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4924 CAMPBELL BLVD SUITE 130 |
| City | NOTTINGHAM |
| State | MD |
| Zip Code | 21236-5908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114404332 | Anthony Trinh | Physical Therapist | 4924 Campbell Blvd, Nottingham, MD 21236-5908 | 2018-07-20 |
| 1255875134 | Maureen Luthardt | Nurse Practitioner | 4924 Campbell Blvd, Suite 200, Nottingham, MD 21236-5908 | 2016-12-12 |
| 1003363854 | Kathryn Kloss | Nurse Practitioner | 4924 Campbell Blvd, #200, Nottingham, MD 21236-5908 | 2016-09-08 |
| 1356797773 | Jennifer Zanni | Physical Therapist | 4924 Campbell Blvd, Suite 130a, Nottingham, MD 21236-5908 | 2016-05-05 |
| 1851772024 | Elizabeth Ault | Physical Therapy Assistant | 4924 Campbell Blvd, Ste. 130a, Nottingham, MD 21236-5908 | 2015-06-14 |
| 1437559580 | Physiotherapy Corporation | Clinic/Center | 4924 Campbell Blvd, Suite 130a, Nottingham, MD 21236-5908 | 2014-08-26 |
| 1407261720 | Jessica Minacapelli Miele | Physical Therapist | 4924 Campbell Blvd, Suite 130a, Nottingham, MD 21236-5908 | 2014-06-25 |
| 1336408160 | Ethel Mojoko | Internal Medicine | 4924 Campbell Blvd, #200, Nottingham, MD 21236-5908 | 2012-05-14 |
| 1477849149 | Kristen Shaw Deitchman | Pediatrics | 4924 Campbell Blvd, Suite 200, Nottingham, MD 21236-5908 | 2011-06-21 |
| 1003123027 | Danielle R. North | Physician Assistant | 4924 Campbell Blvd, Suite 200, Nottingham, MD 21236-5908 | 2010-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381467 | Monique Gaston | Counselor | Well Life Counseling and Consulting, 9649 Belair Road, Ste. 104, Nottingham, MD 21236 | 2020-09-17 |
| 1215575519 | Bh Brightview Perry Hall Opco, LLC | Alzheimer Center (Dementia Center) | 9657 Belair Road, Nottingham, MD 21236 | 2019-12-17 |
| 1750929493 | Bh Brightview White Marsh Opco, LLC | Alzheimer Center (Dementia Center) | 8100 Rossville Blvd., Baltimore, MD 21236 | 2019-12-12 |
| 1083257646 | Matthew Peter Halstad | Behavioral Analyst | 8090 Sandpiper Circle, Nottingham, MD 21236 | 2019-10-25 |
| 1609331602 | Tunisia Buise | Social Worker | 4132 E. Joppa Road Ste. 110-#1248, Baltimore, MD 21236 | 2019-02-04 |
| 1730673047 | Golden Jemz Adult Medical Day | Clinic/Center | 5020 Cambell Blvd, Nottingham, MD 21236 | 2018-06-20 |
| 1487143400 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 7984 Honeygo Blvd, Nottingham, MD 21236 | 2018-05-04 |
| 1619478922 | Weis Markets, Inc. | Pharmacy | 7927 Belair Rd Ste S, Nottingham, MD 21236 | 2018-02-22 |
| 1285133918 | Joan Rosa Keller | Behavior Technician | 3501 Taylor Ave., Baltimore, MD 21236 | 2018-02-08 |
| 1205341146 | Ebony Watkins | Nurse Practitioner | 8940 Kilkenny Circle, Nottingham, MD 21236 | 2017-12-13 |
| Find all providers in zip 21236 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541404 | Aaron Mccauley | Physician Assistant | 3 Dunhaven Pl Apt 2d, Nottingham, MD 21236-3161 | 2020-09-03 |
| 1235568817 | Lance Burgess | Physician Assistant | 8100 Sandpiper Cir, Suite 210, Nottingham, MD 21236-4991 | 2013-11-05 |
| 1003123027 | Danielle R. North | Physician Assistant | 4924 Campbell Blvd, Suite 200, Nottingham, MD 21236-5908 | 2010-09-13 |
| 1013245281 | Monica Thomas | Physician Assistant | 8100 Sandpiper Cir, St. 214, Nottingham, MD 21236-4991 | 2009-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659325 | Stephanie Liss | Physician Assistant | 1003 Willowleaf Way, Potomac, MD 20854-2937 | 2020-11-05 |
| 1306447495 | Naftali Zapinsky | Physician Assistant | 3507 Labyrinth Rd, Baltimore, MD 21215-1731 | 2020-11-04 |
| 1306447768 | Elizabeth Kolbe Schneider | Physician Assistant | 2205 Deadora Dr, Bel Air, MD 21015-8521 | 2020-11-03 |
| 1982204160 | Bich-hanh Le | Physician Assistant | 16328 Decker Pl, Derwood, MD 20855-2181 | 2020-10-28 |
| 1972102416 | Francesca Mertan | Physician Assistant | 829 Concorde Cir Apt 4402, Linthicum Heights, MD 21090-1780 | 2020-10-24 |
| 1235738683 | Ester Dahee Kim | Physician Assistant | 2400 W Belvedere Ave, Baltimore, MD 21215-5216 | 2020-10-17 |
| 1245838804 | Erin Washington | Physician Assistant | 2708 Tallowtree Rd, Woodstock, MD 21163-1462 | 2020-10-15 |
| 1669070991 | Niklavs Peteris Eglitis | Physician Assistant | 905 Paulsboro Dr, Rockville, MD 20850-3027 | 2020-10-09 |
| 1922605583 | Kurt William Moulton | Physician Assistant | Health Center At Ward and West 8000 York Rd, Towson, MD 21252-0001 | 2020-10-07 |
| 1184236234 | Sosy Tatarian | Physician Assistant | 20214 Peach Grove Ln, Dickerson, MD 20842-9112 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | NOTTINGHAM |
| Zip Code | 21236 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.