Mary M Kennedy, R.N., N.P., C.N.M.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

177602 Issued in CA

Practice address

7601 Stoneridge Dr
The Permanente Medical Group
Pleasanton, CA 94588-4501

Phone

(925) 847-5629

Fax

(925) 847-5148

NPI assigned

Sep 8, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083608780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 STONERIDGE DR",
            "address_2": "THE PERMANENTE MEDICAL GROUP",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884501",
            "telephone_number": "925-847-5629",
            "fax_number": "925-847-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 STONERIDGE DR",
            "address_2": "THE PERMANENTE MEDICAL GROUP",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884501",
            "telephone_number": "925-847-5629",
            "fax_number": "925-847-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "R.N., N.P., C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "177602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "177602",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melisa Kelley, PHARMD
• Chloe Kellum
• Johanna Helen Kelly, LMFT
• Kerry-Ann Alyscia Kelly, MD
• Mary Kennard, MA, MFT INTERN
• Anna Rebecca Kerr, MD
• Archana Kesavamurthi
• Ambarene Khader
• Gulagha Khalili
• Frieda Khan

• Women's Health Nurse Practitioner in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.