Active NPI
Caleb A Kennon, MD
- Anesthesiology Physician
- Newark, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 35.154451
- Practice address
- 1320 W Main St
Newark, OH 43055-1822 - Phone
- (220) 564-4201
- Fax
- (220) 564-4219
- NPI assigned
- Mar 19, 2019
- Last updated
- Oct 10, 2025
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 71867 | TN | |
| Anesthesiology Physician | 207L00000X | 35.154451 | OH | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 58148 | KY |
Addresses
Primary practice location
1320 W Main St
Newark, OH 43055-1822
Mailing address
1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4201
Other practice location 1
2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011 ext. 402
Other practice location 2
800 Rose St
Lexington, KY 40536-0293
Phone (859) 323-5956
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ckennon44093@lickingmemorial.medicity.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, TN, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Missouri, Kansas City, School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1320 W Main St
Licking Memorial Anesthesiology
Newark, OH 43055-1822
Phone (220) 564-4226
2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011
800 Rose St
Lexington, KY 40536-0001
Phone (859) 323-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watauga Orthopaedics PLC | Current | Accepting new patients | |
| Licking Memorial Health Professionals | Current | Accepting new patients | |
| Kentucky Medical Services Foundation, Inc | Anesthesiology | Current | Accepting new patients |
| Licking Memorial Professional Corporation | Current | Accepting new patients | |
| Watauga Orthopaedics, PLC | Current | Accepting new patients | |
| University of Kentucky | Current | Accepting new patients | |
| Licking Memorial Professional Corporation | Current | Accepting new patients | |
| Licking Memorial Professional Corp. | Past | Accepting new patients |
Locations
2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800
800 Rose St
Lexington, KY 40536
Phone (859) 257-8562
120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806
1320 W Main St
Newark, OH 43055
Phone (740) 348-4151
2000 Tamarack Rd
Newark, OH 43055
Phone (740) 788-6000
340 Steeles Rd
Bristol, TN 37620
Phone (423) 282-9011
2410 Susannah St
Johnson City, TN 37601
Phone (423) 282-9011
2412 Susannah St
Johnson City, TN 37601
Phone (423) 282-8070
875 Larry Neil Way
Kingsport, TN 37660
Phone (423) 282-9011
Interoperability endpoints
- caleb.kennon.1@3374.direct.athenahealth.com
- ckennon33663@ukhcdirect.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Newark, OH
- NPI 1326072265
-
- Internal Medicine Physician
- Lexington, KY
- NPI 1326091448
Anesthesiology
-
- Orthopaedic Surgery Physician
- Johnson City, TN
- NPI 1245251404
-
- Diagnostic Radiology Physician
- Lexington, KY
- NPI 1770771974
-
dba Licking Memorial Orthopedic DME
- Durable Medical Equipment & Medical Supplies
- Newark, OH
- NPI 1326436510
-
dba Licking Memorial Pathologists
- Anatomic Pathology & Clinical Pathology Physician
- Newark, OH
- NPI 1932186053
-
- Durable Medical Equipment & Medical Supplies
- Greeneville, TN
- NPI 1730924192
-
dba Licking Memorial Pediatrics-Utica
- Pediatrics Physician
- Utica, OH
- NPI 1497771521
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newark, OH
- NPI 1568446755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760054400000",
"number": "1144789918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 W MAIN ST",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551822",
"telephone_number": "220-564-4201",
"fax_number": "220-564-4219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 W MAIN ST",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551822",
"telephone_number": "220-564-4201",
"fax_number": "220-564-4219"
}
],
"practiceLocations": [
{
"address_1": "2410 Susannah St",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376011748",
"country_code": "US",
"telephone_number": "423-282-9011 x402",
"fax_number": "423-282-0035",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "800 Rose St",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405360293",
"country_code": "US",
"telephone_number": "859-323-5956",
"fax_number": "859-323-1080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENNON",
"first_name": "CALEB",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-19",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TN",
"license": "71867",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OH",
"license": "35.154451",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KY",
"license": "58148",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ckennon44093@lickingmemorial.medicity.net",
"affiliation": "N",
"address_1": "1320 W Main St",
"city": "Newark",
"state": "OH",
"country_code": "US",
"postal_code": "430551822",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.