Diana L. Kennedy, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

13883 Issued in OK

Practice address

4205 McAuley Blvd
Suite 420
Oklahoma City, OK 73120-8347

Phone

(405) 751-6111

Fax

(405) 751-0479

NPI assigned

Aug 28, 2006

Sex

Female

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 OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1053429159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 MCAULEY BLVD",
            "address_2": "SUITE 420",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208347",
            "telephone_number": "405-751-6111",
            "fax_number": "405-751-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 MCAULEY BLVD",
            "address_2": "SUITE 420",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208347",
            "telephone_number": "405-751-6111",
            "fax_number": "405-751-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DIANA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OK",
            "license": "13883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kendrick, PH.D.
• Keanndra Kendrick
• Barbara Ann Kennedy, LMSW
• Denise Kennedy
• Denise Kennedy
• Douglas Kennedy
• Jennifer Rose Kennedy, RBT
• Jessica Lee Kennedy, LMSW
• Karisa Jo Kennedy, NP
• Kathleen Anne Kennedy, MSCP

• Endocrinology, Diabetes & Metabolism Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Endocrinology, Diabetes & Metabolism Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.