Individual provider Active NPI

Tamara Yvette Kennedy, FNP

  • Family Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1124311634
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R175373 Issued in MD
Practice address
2601 Riva Rd
Annapolis, MD 21401-7304
Phone
(240) 392-2294
Fax
(240) 392-2294
NPI assigned
May 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R175373 MD Primary

Addresses

Primary practice location

2601 Riva Rd
Annapolis, MD 21401-7304

Mailing address

8105 Picard LN
Upper Marlboro, MD 20774-4729
Phone (240) 392-2294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110719000049 MD Practitioner - Nurse Practitioner 4587832589 Reassigns benefits to 1 organization
I20110719000075 DC Practitioner - Nurse Practitioner 4587832589 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dimensions Healthcare Associates, IncGroup PAC ID 1557269743, 198 clinicians

Practice addresses (Care Compare)

901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477
Phone (240) 677-3000

Merit-based Incentive Payment System (MIPS)

Final score
96.64 of 100Reported as group
Quality
88.96
Promoting interoperability
100
Improvement activities
40
Cost
73.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R175373MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince May 28, 2013 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince May 28, 2013 Accepting new patients
Dimensions Healthcare Associates Inc CurrentSince Aug 23, 2023 Accepting new patients
Dimensions Healthcare Associates, Inc. Current Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Aug 23, 2023 Accepting new patients
Dimensions Healthcare Associates Inc Past Accepting new patients

Locations

201 Defense Hwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-6549

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

7150 Contee Rd
Laurel, MD 20707
Phone (240) 677-7200

251 National Harbor Blvd
Fl 5
Oxon Hill, MD 20745
Phone (301) 618-2273

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Interoperability endpoints

  • Direct secure messaging: tkennedy1029963@direct.umm.edu

Organizations & group practices 8

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": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1124311634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 PICARD LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207744729",
            "telephone_number": "240-392-2294",
            "fax_number": "240-392-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 RIVA RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017304",
            "telephone_number": "240-392-2294",
            "fax_number": "240-392-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "TAMARA",
        "middle_name": "YVETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R175373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.