Michael Kenney, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

01353 Issued in MO

Practice address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone

(314) 577-5667

NPI assigned

May 26, 2006

Last updated

Nov 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkenney18715@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SSM Cardinal Glennon Childrens Hospital

  dba SSM Health Cardinal Glennon Children's Hospital

  • Pediatrics Physician
  • O'Fallon, IL
  • NPI 1174577670

  MO

  Medicare reassignment
• SSM Cardinal Glennon Childrens Hospital

  dba SSM Health Cardinal Glennon Pediatrics

  • Pediatrics Physician
  • Saint Louis, MO
  • NPI 1073568226
  NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1073569349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10777 Sunset office Dr.",
            "address_2": "Suite 315",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "63127",
            "country_code": "US",
            "telephone_number": "314-965-0101",
            "fax_number": "314-965-2562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "MICHAEL",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "01353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493318406",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkenney18715@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mkenney18715@direct-ehr-ssmhc.com",
            "address_1": "1465 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Kenney
• Claire Therese Kenney, MD, PHD
• Isabella Maria Kenney, MSW, LCSW
• Kaitlin G Kenney, MD
• Katalin Kenney, PA
• Christina Kennon, R.N.
• Kristy D Kennon, MSN, RN, CPNP
• Sarah Kenny, PA
• Brooke Kensler
• Elizabeth Jean Kent, MD

• Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.