Individual provider Active NPI

Tina Angela Kenney, BC-HIS

  • Hearing Instrument Specialist
  • Louisville, KY
National Provider Identifier
1063540219
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
101271 Issued in KY
Practice address
2944 Breckenridge LN
Louisville, KY 40220-1409
Phone
(502) 893-0159
Fax
(502) 213-3853
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 17001508A IN
Hearing Instrument Specialist 237700000X 101271 KY Primary

Addresses

Primary practice location

2944 Breckenridge LN
Louisville, KY 40220-1409

Mailing address

103 Glendale Dr
Charlestown, IN 47111-1708
Phone (502) 386-9144

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

State licenses

LicenseStateTypeSpecialty
17001508AINMDHearing Instrument Specialist
101271KYMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1063540219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 GLENDALE DR",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471111708",
            "telephone_number": "502-386-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2944 BRECKENRIDGE LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201409",
            "telephone_number": "502-893-0159",
            "fax_number": "502-213-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "TINA",
        "middle_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "BC-HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IN",
            "license": "17001508A",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "KY",
            "license": "101271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.