Larry Ray Kennon, APRN, BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

061052 Issued in MO

Practice address

1137 Independence Dr
West Plains, MO 65775-4221

Phone

(417) 255-8464

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Rural Alliance for Better Family Health

  • Federally Qualified Health Center (FQHC)
  • Thayer, MO
  • NPI 1164488680
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1003803370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 COUNTY ROAD 9900",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657756797",
            "telephone_number": "417-255-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 INDEPENDENCE DR",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754221",
            "telephone_number": "417-255-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNON",
        "first_name": "LARRY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "061052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "000013700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "261882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "261863",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428580211",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Keeling, PHARM.D.
• Galen Arthur Kellenberger, D.D.S.
• Clara H Keller
• Elizabeth Kelly
• Kelsie Rasor Chiropractic
• Scott Kenslow, PA-C
• Susan Kenslow
• Amber Lynn Kerley
• Harley Kerley
• Lesa Kerley, CRNP

• Family Nurse Practitioner in West Plains, MO
• Providers in West Plains, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.