Active NPI
Matthew Kennedy, RPH
- Pharmacist
- Saint Cloud, FL
National Provider Identifier
1003956582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS 35597
- Practice address
- 3318 Canoe Creek Rd
Saint Cloud, FL 34772-6511 - Phone
- (407) 892-7103
- Fax
- (407) 957-2369
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS 35597 | FL | Primary |
Addresses
Primary practice location
3318 Canoe Creek Rd
Saint Cloud, FL 34772-6511
Mailing address
511 Neptune Bay Cir
Unit 8
Saint Cloud, FL 34769-7026
Phone (321) 766-2607
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 35597 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003956582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 NEPTUNE BAY CIR",
"address_2": "UNIT 8",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347697026",
"telephone_number": "321-766-2607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3318 CANOE CREEK RD",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347726511",
"telephone_number": "407-892-7103",
"fax_number": "407-957-2369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MATTHEW",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 35597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.