Active NPI
Harold Lloyd Kennedy, MD MPH
- Public Health & General Preventive Medicine Physician
- Saint Louis, MO
National Provider Identifier
1104044114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- MD 29940
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071217000063 | MO | Practitioner - Internal Medicine | 8224128152 | Practice locations: Saint Louis, MO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 29940 | MO | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taos Medical Group P a | Past | Accepting new patients | |
| Poplar Bluff Hma Physician Management, LLC | Cardiovascular Disease | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Family Medicine Physician
- Poplar Bluff, MO
- NPI 1598710147
Cardiovascular Disease
-
- Internal Medicine Physician
- Taos, NM
- NPI 1558392274
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.