Active NPI
Billie Jo Kennett, APN
- Adult Health Nurse Practitioner
- Martin, TN
National Provider Identifier
1124085519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APN0000005195
- Practice address
- 215 Hawks Rd
Suite 6
Martin, TN 38237-2708 - Phone
- (731) 587-3454
- Fax
- (731) 587-3460
- NPI assigned
- Apr 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | APN0000005195 | TN | Primary |
Addresses
Primary practice location
215 Hawks Rd
Suite 6
Martin, TN 38237-2708
Mailing address
215 Hawks Rd
Suite 6
Martin, TN 38237-2708
Phone (731) 587-3454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3341684 | Medicaid | TN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5195 | TN | MD | Physical Therapy Assistant |
| APN0000005195 | TN | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427068800000",
"number": "1124085519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 HAWKS RD",
"address_2": "SUITE 6",
"city": "MARTIN",
"state": "TN",
"postal_code": "382372708",
"telephone_number": "731-587-3454",
"fax_number": "731-587-3460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 HAWKS RD",
"address_2": "SUITE 6",
"city": "MARTIN",
"state": "TN",
"postal_code": "382372708",
"telephone_number": "731-587-3454",
"fax_number": "731-587-3460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNETT",
"first_name": "BILLIE",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-28",
"last_updated": "2015-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TN",
"license": "APN0000005195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3341684",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Martin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.