Individual provider Active NPI

Billie Jo Kennett, APN

  • Adult Health Nurse Practitioner
  • Martin, TN
National Provider Identifier
1124085519
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN0000005195 Issued in TN
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

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3341684MedicaidTN

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

LicenseStateTypeSpecialty
5195TNMDPhysical Therapy Assistant
APN0000005195TNMDAdult 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.

Verify at the official NPI Registry.