NPIMap

Individual provider Active NPI

Kimberly Kennedy

  • Family Medicine Physician
  • Rapid City, SD
National Provider Identifier
1003103664
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9251 Issued in SD
Practice address
101 E Minnesota St
Suite 210
Rapid City, SD 57701-7756
Phone
(605) 342-3280
Fax
(605) 721-8412
NPI assigned
Jul 5, 2011
Last updated
Aug 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9251 SD Primary

Addresses

Primary practice location

101 E Minnesota St
Suite 210
Rapid City, SD 57701-7756

Mailing address

PO Box 6020
Rapid City, SD 57709-6020
Phone (605) 342-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922002930 SD Practitioner - Family Practice 0941429096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. CurrentSince Nov 22, 2016 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Nov 11, 2015 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Network, Inc. Family Medicine CurrentSince Nov 22, 2016 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Nov 11, 2015 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

502 E Monroe St
Rapid City, SD 57701
Phone (605) 719-4060

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

Interoperability endpoints

  • FHIR API: https://ehrmobile.monument.health/interconnect-prd-fhir/api/FHIR/R4/
  • Direct secure messaging: kkennedy.8503@regionalhealth.sdhealthlink.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1003103664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6020",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096020",
            "telephone_number": "605-342-3280",
            "fax_number": "605-721-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MINNESOTA ST",
            "address_2": "SUITE 210",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017756",
            "telephone_number": "605-342-3280",
            "fax_number": "605-721-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "9251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.