Active NPI
Tana L. Kenley, PA-C
- Physician Assistant
- Beatrice, NE
National Provider Identifier
1174977946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1862
- Practice address
- 3000 Lincoln St
Beatrice, NE 68310-3319 - Phone
- (402) 239-9920
- NPI assigned
- Apr 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1862 | NE | Primary |
Addresses
Primary practice location
3000 Lincoln St
Beatrice, NE 68310-3319
Mailing address
28154 S 36TH Rd
Beatrice, NE 68310-5737
Phone (402) 806-5970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160706000415 | NE | Practitioner - Physician Assistant | 8729370150 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1862 | NE | MD | Mental Health Counselor |
Organizations & group practices 1
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": "1461024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461024000000",
"number": "1174977946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28154 S 36TH RD",
"city": "BEATRICE",
"state": "NE",
"postal_code": "683105737",
"telephone_number": "402-806-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 LINCOLN ST",
"city": "BEATRICE",
"state": "NE",
"postal_code": "683103319",
"telephone_number": "402-239-9920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENLEY",
"first_name": "TANA",
"middle_name": "L.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-19",
"last_updated": "2016-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "1862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beatrice, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.