Alexander Woodward Kennon, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME136268 Issued in FL

Practice address

727 US Highway 27 S
Sebring, FL 33870-2169

Phone

(863) 385-7183

NPI assigned

Jun 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Undefined Physician Type (Specify)Also: Dermatology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeside Dermatology LLCGroup PAC ID 9537595194, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
• Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Lakeside Dermatology LLC

  • Dermatology Physician
  • Sebring, FL
  • NPI 1922257260
  Medicare reassignment Care Compare group NPD
• Michael J Rogers

  • Dermatology Physician
  • Sebring, FL
  • NPI 1003876053
  Medicare reassignment
• Lakeside Dermatology , PA

  • Dermatology Physician
  • Cornelius, NC
  • NPI 1619973054
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System-Sunbelt Inc

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Care Compare affiliation
• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  Care Compare affiliation

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1053675868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 US HIGHWAY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338702169",
            "telephone_number": "863-385-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 US HIGHWAY 27 S",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338702169",
            "telephone_number": "863-385-7183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Coliseum Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173865",
            "country_code": "US",
            "telephone_number": "478-742-2180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 US Highway 27 S",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "338702169",
            "country_code": "US",
            "telephone_number": "863-385-7183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Avenue K SE Ste 3",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338804123",
            "country_code": "US",
            "telephone_number": "863-293-7546",
            "fax_number": "863-294-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNON",
        "first_name": "ALEXANDER",
        "middle_name": "WOODWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME136268",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME136268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Michael Kane, MD
• Sanjay Karatam, M.D.
• Melissa Keiber, PHARMD
• Gregory Robert Keith, PT
• Karen Lynn Kelly-Carr, ARNP,FNP
• Everett Richard Kessler Jr., PHARMD
• Kevin M Meyer Mdpa
• Kevin M. Strathy, M.D., PA
• Sabiha S Khadim, M.D.
• Anya Khan, APRN

• MOHS-Micrographic Surgery Physician in Sebring, FL
• Providers in Sebring, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.
• 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.