Active NPI
Rachel E. Kennedy, D.O.
- Family Medicine Physician
- Decatur, AL
National Provider Identifier
1164629002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO-1083
- Practice address
- 2422 Danville Rd.
Suite E
Decatur, AL 35603 - Phone
- (256) 355-9040
- Fax
- (256) 355-9048
- NPI assigned
- Jul 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO-1083 | AL | Primary |
| Family Medicine Physician | 207Q00000X | 2015-02452 | NC | |
| Family Medicine Physician | 207Q00000X | 34.012102 | OH | |
| Family Medicine Physician | 207Q00000X | 03953 | KY | |
| Family Medicine Physician | 207Q00000X | 0102204445 | VA | |
| Family Medicine Physician | 207Q00000X | 3036 | TN | |
| Family Medicine Physician | 207Q00000X | 39364 | SC | |
| Family Medicine Physician | 207Q00000X | DO034561 | DC | |
| Family Medicine Physician | 207Q00000X | 17704 | NH | |
| Family Medicine Physician | 207Q00000X | 076649 | GA | |
| Family Medicine Physician | 207Q00000X | OS14309 | FL | |
| Family Medicine Physician | 207Q00000X | R0735 | TX | |
| Family Medicine Physician | 207Q00000X | 3140 | WV | |
| Family Medicine Physician | 207Q00000X | E-10242 | AR |
Addresses
Primary practice location
2422 Danville Rd.
Suite E
Decatur, AL 35603
Mailing address
P.O. Box 5750
Decatur, AL 35601
Phone (256) 355-9040
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39364 | SC | MD | Pharmacy Technician |
| DO-1083 | AL | MD | Family Medicine Physician |
| E-10242 | AR | MD | Family Medicine Physician |
| DO034561 | DC | MD | Family Medicine Physician |
| OS14309 | FL | MD | Family Medicine Physician |
| 076649 | GA | MD | Family Medicine Physician |
| 03953 | KY | MD | Family Medicine Physician |
| 2015-02452 | NC | MD | Family Medicine Physician |
| 17704 | NH | MD | Family Medicine Physician |
| 34.012102 | OH | MD | Family Medicine Physician |
| R0735 | TX | MD | Family Medicine Physician |
| 0102204445 | VA | MD | Family Medicine Physician |
| 3140 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Gill Family Medicine, P.C. | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- rachel.kennedy.1@30520.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Decatur, AL
- NPI 1144574872
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1164629002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 5750",
"city": "DECATUR",
"state": "AL",
"postal_code": "35601",
"telephone_number": "256-355-9040",
"fax_number": "256-355-9048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2422 DANVILLE RD.",
"address_2": "SUITE E",
"city": "DECATUR",
"state": "AL",
"postal_code": "35603",
"telephone_number": "256-355-9040",
"fax_number": "256-355-9048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "RACHEL",
"middle_name": "E.",
"name_prefix": "Mrs.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-02",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "DO-1083",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2015-02452",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34.012102",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "03953",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0102204445",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "3036",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "39364",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "DC",
"license": "DO034561",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "17704",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "076649",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS14309",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "R0735",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "3140",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-10242",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.