Individual provider Active NPI

Kennedy Parham, WHNP

  • Women's Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1043101777
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
421876 Issued in NY
Practice address
1120 E Genesee St
Syracuse, NY 13210-1994
Phone
(866) 600-6886
Fax
(315) 475-5554
NPI assigned
Jul 11, 2025
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 421876 NY Primary
Registered Nurse 163W00000X 986991 NY

Addresses

Primary practice location

1120 E Genesee St
Syracuse, NY 13210-1994

Mailing address

114 University Ave
Rochester, NY 14605-2992
Phone (315) 496-3824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813002048 NY Practitioner - Nurse Practitioner 2264930734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planned Parenthood of Central and Western New York IncGroup PAC ID 6406848647, 19 clinicians

Practice addresses (Care Compare)

1120 E Genesee St
Syracuse, NY 13210-1912
Phone (315) 475-5540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
986991NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Central and Western New York, Inc Women's Health CurrentSince Jul 21, 2025 Accepting new patients

Locations

15 Webster St
North Tonawanda, NY 14120
Phone (716) 694-1225

114 University Ave
Rochester, NY 14605
Phone (585) 546-2771

1120 E Genesee St
Syracuse, NY 13210
Phone (315) 475-5540

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kennedy.parhamnp.p4@direct.usppny.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1043101777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 UNIVERSITY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146052992",
            "telephone_number": "315-496-3824",
            "fax_number": "585-546-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101994",
            "telephone_number": "866-600-6886",
            "fax_number": "315-475-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "KENNEDY",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421876",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "986991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.