Jared R Kennedy, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.011926 Issued in IL

Practice address

2035 W Iles Ave
Suite a
Springfield, IL 62704-4192

Phone

(217) 787-9100

Fax

(217) 787-6616

NPI assigned

Mar 3, 2011

Sex

Male

Sole proprietor

Yes

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 IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Babu Prasad, MD

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  • Springfield, IL
  • NPI 1215552880
  NPD (past)
• Springfield Accident and Pain Center

  • Chiropractor
  • Springfield, IL
  • NPI 1912940248
  NPD (past)

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1033417746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 W ILES AVE",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044192",
            "telephone_number": "217-787-9100",
            "fax_number": "217-787-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 W ILES AVE",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044192",
            "telephone_number": "217-787-9100",
            "fax_number": "217-787-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JARED",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Kendall, LCSW
• Kristen Elaine Kendall, M.D.
• Kendrick & Jones Dental, LLC
• Samuel D Kendrick, DMD
• April Kennedy, DDS
• Linda L. Kennedy, RN, RT(R)
• Madison Kennedy
• Michelle Kennedy, RSA
• Monica Nicole Kennedy, LSW
• Roxanne M Kennedy, LCPC

• Chiropractor in Springfield, IL
• Providers in Springfield, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.