Active NPI
Elizabeth Jane Kennedy, PAC
- Physician Assistant
- Lexington, KY
National Provider Identifier
1063528107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA311
- Practice address
- 1401 Harrodsburg Rd
Suite C-305
Lexington, KY 40504-3751 - Phone
- (859) 278-8400
- Fax
- (859) 276-3700
- NPI assigned
- Aug 22, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA311 | KY | Primary |
Addresses
Primary practice location
1401 Harrodsburg Rd
Suite C-305
Lexington, KY 40504-3751
Mailing address
PO Box 936
London, KY 40743-0936
Phone (606) 330-7818
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA311 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Family Physicians PSC | Past | Accepting new patients | |
| Fayette Family Medicine, PSC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Lexington, KY
- NPI 1821133141
-
- Family Medicine Physician
- Lexington, KY
- NPI 1598896938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564704000000",
"number": "1063528107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936",
"city": "LONDON",
"state": "KY",
"postal_code": "407430936",
"telephone_number": "606-330-7818",
"fax_number": "606-330-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 HARRODSBURG RD",
"address_2": "SUITE C-305",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043751",
"telephone_number": "859-278-8400",
"fax_number": "859-276-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ELIZABETH",
"middle_name": "JANE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2019-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.