Individual provider Active NPI

Harold Lloyd Kennedy, MD MPH

  • Public Health & General Preventive Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1104044114
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD 29940 Issued in MO
Practice address
6420 Clayton Rd.
1031 B Midwest Cardiovascular
Saint Louis, MO 63132
Phone
(314) 644-5650
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD 29940 MO
Public Health & General Preventive Medicine Physician 2083P0901X MD 29940 MO Primary

Addresses

Primary practice location

6420 Clayton Rd.
1031 B Midwest Cardiovascular
Saint Louis, MO 63132

Mailing address

5 Apple Tree LN
Saint Louis, MO 63124-1601
Phone (314) 993-4408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000063 MO Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 8224128152 Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 29940MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Taos Medical Group P a Past Accepting new patients
Poplar Bluff Hma Physician Management, LLC Cardiovascular Disease Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2636/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104044114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 APPLE TREE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241601",
            "telephone_number": "314-993-4408",
            "fax_number": "314-993-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD.",
            "address_2": "1031 B MIDWEST CARDIOVASCULAR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63132",
            "telephone_number": "314-644-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "HAROLD",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "MD 29940",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MO",
            "license": "MD 29940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.