Individual provider Active NPI

Rachel E. Kennedy, D.O.

  • Family Medicine Physician
  • Decatur, AL
National Provider Identifier
1164629002
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-1083 Issued in AL
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

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
39364SCMDPharmacy Technician
DO-1083ALMDFamily Medicine Physician
E-10242ARMDFamily Medicine Physician
DO034561DCMDFamily Medicine Physician
OS14309FLMDFamily Medicine Physician
076649GAMDFamily Medicine Physician
03953KYMDFamily Medicine Physician
2015-02452NCMDFamily Medicine Physician
17704NHMDFamily Medicine Physician
34.012102OHMDFamily Medicine Physician
R0735TXMDFamily Medicine Physician
0102204445VAMDFamily Medicine Physician
3140WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Gill Family Medicine, P.C. Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.