Kenne William Kennemer, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2403 Professional Dr
Suite 101
Santa Rosa, CA 95403-3007

Phone

(707) 544-3295

Fax

(707) 544-9011

NPI assigned

Jun 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Marriage and Family Therapist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of SonomaGroup PAC ID 4688658651, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Sonoma

  • Community Health Clinic/Center
  • Cloverdale, CA
  • NPI 1952637027
  Medicare reassignment Care Compare group NPD
• County of Sonoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Rosa, CA
  • NPI 1306050828
  NPD
• County of Sonoma

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1457498636
  NPD
• Drug Abuse Alternatives Center

  dba Outpatient

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Santa Rosa, CA
  • NPI 1063623593
  NPD (past)
• Drug Abuse Alternatives Center

  dba Redwood Empire Addiction Program

  • Methadone Clinic
  • Santa Rosa, CA
  • NPI 1629289152
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114121621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR",
            "address_2": "SUITE 101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-544-3295",
            "fax_number": "707-544-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR",
            "address_2": "SUITE 101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-544-3295",
            "fax_number": "707-544-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEMER",
        "first_name": "KENNE",
        "middle_name": "WILLIAM",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Kennedy, O.D., FAAO
• Eleanna Alexia Kennedy
• Jane E Kennedy, NP
• Kimberly Anne Kennedy
• Ron Kennedy, M.D.
• Kyrie Kennemore
• Kenneth J. Bauer, DDS, a Professional Corporation
• Alex M Kennett
• James Kenney, PHARM.D.
• Scott Kensinger, MS, CCC-SLP

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.