Ryan Kennard, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

1035 Peach St Ste 204
San Luis Obispo, CA 93401-2700

Phone

(805) 476-6212

Fax

(805) 269-8091

NPI assigned

Jul 18, 2014

Last updated

Dec 15, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Qualified Audiologist

Education

At Still University, Arizona School of Dentistry & Oral HLTH, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Coast Audiology, Inc.

  • Audiologist
  • San Luis Obispo, CA
  • NPI 1063124527
  Medicare reassignment NPD Authorized official
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1023425337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST STE 204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-476-6212",
            "fax_number": "805-269-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST STE 204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-476-6212",
            "fax_number": "805-269-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNARD",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-18",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Davis Kellogg
• Madeline Grace Kelly
• Patrick Kelly
• Alexandra Kelso
• Kyle Richard Kelson, MD
• Amaia Sophia Kennedy
• Ezery Kennedy Jr.
• Timothy Kennedy
• Kenneth L Baldwin M D Inc
• Kenneth P. Tway, M.D., F.a.C.C., Inc.

• Audiologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.