Robert Michael Kennedy, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

M4241 Issued in ID

Practice address

777 Hospital Way
G15
Pocatello, ID 83201-5175

Phone

(208) 239-2722

Fax

(208) 239-3759

NPI assigned

Jul 16, 2005

Last updated

Jan 31, 2013By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Pocatello Health Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
  • NPI 1154089126
  NPD
• Pocatello Health Services, LLC

  dba Portneuf Medical Practices

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1215165485
  NPD
• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  NPD

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

{
    "created_epoch": "1121472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1043219694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "address_2": "G15",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-2722",
            "fax_number": "208-239-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "address_2": "G15",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-2722",
            "fax_number": "208-239-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-16",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ID",
            "license": "M4241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Kellum, DDS
• Kemp Dental LLC
• Larry J Kemp, D.D.S.
• Kendra Westerhaus PHD LLC
• Titus Kener
• Kenneth P. Lindsey, PHD, PA
• Amie Beth Kenyen, NP-C
• Serene Kergaye, DO
• Terry Jeanne Kerler, LPC
• Caroline J Kerr, M.S., CCC-A

• Neurology Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Neurology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.