Active NPI
Charles Kennedy, D.O.
- Internal Medicine Physician
- Salisbury, NC
National Provider Identifier
1124477708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- WV3462
- Practice address
- 1601 Brenner Ave
Salisbury, NC 28144-2515 - Phone
- (704) 638-9000
- NPI assigned
- Jun 6, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | WV3462 | WV | Primary |
Addresses
Primary practice location
1601 Brenner Ave
Salisbury, NC 28144-2515
Mailing address
500 Cherry Street
Bluefield Regional Medical Center
Bluefield, WV 24701
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WV3462 | WV | MD | Internal Medicine Physician |
Interoperability endpoints
- charles.kennedy.1@2694.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1124477708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 CHERRY STREET",
"address_2": "BLUEFIELD REGIONAL MEDICAL CENTER",
"city": "BLUEFIELD",
"state": "WV",
"postal_code": "24701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 BRENNER AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442515",
"telephone_number": "704-638-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-06",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WV",
"license": "WV3462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.