Michelle Kenney, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2018008509 Issued in MO

Practice address

402 W Jefferson St
Kirksville, MO 63501-3407

Phone

(660) 627-2229

NPI assigned

Jun 25, 2015

Last updated

May 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.kenney.p1@direct.nmhcinc.nextgenshare.com

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.

• Northeast Missouri Health Council, Inc.

  dba Northeast Family Health Clinics

  • Federally Qualified Health Center (FQHC)
  • Kirksville, MO
  • NPI 1104829498

  Pediatrics

  Medicare reassignment NPD
• Northeast Missouri Health Council Inc

  dba Memphis Community Health Center

  • Internal Medicine Physician
  • Memphis, MO
  • NPI 1881307155
  NPD
• Northeast Missouri Health Council, Inc.

  dba OB/GYN Specialty Group/Northeast Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Kirksville, MO
  • NPI 1326184334

  Pediatrics

  NPD
• Kirksville Missouri Hospital Company, LLC

  dba Northeast Regional Medical Center

  • General Acute Care Hospital
  • Kirksville, MO
  • NPI 1104899442
  NPD (past)

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1134501125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CROWN DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012548",
            "telephone_number": "660-627-5757",
            "fax_number": "660-627-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013407",
            "telephone_number": "660-627-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2015017626",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018008509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Levi A Kelly, CRNA
• Matthew Dean Kelly
• Kathleen M Kelso, RN
• Edgar N Kemp III, DO
• Nicholas Kennedy
• Brett A Kerby, PTA
• Maryum Khaja, DDS
• Euslah Kigen
• Melissa B Killen, LMSW
• Chris Kim

• Pediatrics Physician in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.