Active NPI
Mary Lou Kennedy, RN
- Registered Nurse
- Claremore, OK
National Provider Identifier
1053565739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- ROO47499
- Practice address
- 101 S Moore Ave
Claremore, OK 74017-5047 - Phone
- (918) 342-6295
- Fax
- (918) 342-6508
- NPI assigned
- Nov 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | ROO47499 | OK | Primary |
Addresses
Primary practice location
101 S Moore Ave
Claremore, OK 74017-5047
Mailing address
PO Box 548
Sells, AZ 85634
Phone (520) 383-7336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ROO47499 | OK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497312000000",
"number": "1053565739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 548",
"city": "SELLS",
"state": "AZ",
"postal_code": "85634",
"telephone_number": "520-383-7336",
"fax_number": "520-383-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S MOORE AVE",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740175047",
"telephone_number": "918-342-6295",
"fax_number": "918-342-6508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MARY",
"middle_name": "LOU",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-08",
"last_updated": "2017-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OK",
"license": "ROO47499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claremore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.