Active NPI
Patricia Ann Kenaley, FNP
- Family Nurse Practitioner
- Brewer, ME
National Provider Identifier
1083834220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- CNP111119
- Practice address
- 735 Wilson St
Brewer, ME 04412-1000 - Phone
- (207) 989-1567
- Fax
- (207) 989-2287
- NPI assigned
- Apr 30, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 114954 | MA | |
| Family Nurse Practitioner | 363LF0000X | CNP111119 | ME | Primary |
Addresses
Primary practice location
735 Wilson St
Brewer, ME 04412-1000
Mailing address
PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114954 | Other | MA | LICENSE |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP111119 | ME | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1083834220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1599",
"city": "BANGOR",
"state": "ME",
"postal_code": "044021599",
"telephone_number": "207-945-5247",
"fax_number": "207-947-0435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 WILSON ST",
"city": "BREWER",
"state": "ME",
"postal_code": "044121000",
"telephone_number": "207-989-1567",
"fax_number": "207-989-2287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENALEY",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-30",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "114954",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ME",
"license": "CNP111119",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "114954",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brewer, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.