Kelsey Real Kennedy

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD.43941 Issued in AL

Practice address

252 Inverness Center Dr
Birmingham, AL 35242-4834

Phone

(205) 997-2966

Fax

(205) 379-6842

NPI assigned

Apr 10, 2018

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

Other names 1

• Kelsey Caitlin Real Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

University of Alabama School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.74 of 100Reported as group

Quality

100

Improvement activities

40

Cost

79.14

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Mobile, AL
  • NPI 1366936759
  Medicare reassignment Care Compare group NPD
• SSD, LLC

  • Dermatology Physician
  • Birmingham, AL
  • NPI 1134700131
  Medicare reassignment NPD
• Coosa River Dermatology, Inc

  • MOHS-Micrographic Surgery Physician
  • Pell City, AL
  • NPI 1447003579
  NPD Authorized official
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Mountain BRK, AL
  • NPI 1720664907
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1194222844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 INVERNESS CENTER DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424834",
            "telephone_number": "205-997-2966",
            "fax_number": "205-379-6842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Inverness Center Dr",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352424834",
            "country_code": "US",
            "telephone_number": "205-995-5575",
            "fax_number": "205-995-5576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KELSEY",
        "middle_name": "REAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AL",
            "license": "MD.43941",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "MD.43941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelsey.Kennedy@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "250 Inverness Center Dr",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352424834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelsey.Kennedy@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "252 Inverness Center Dr",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352424834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "REAL",
            "middle_name": "CAITLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Kennedy, BCBA, LABA
• John I Kennedy Jr., MD
• Karla G Kennedy, MD
• Kathryn Kennedy, PA-C
• Kayla Kennedy, FNP-C
• Kevin Meers Kennedy, MD
• Kierstin Kennedy
• Lisa A Kennedy, O.D.
• Mallory Kennedy
• Melanie J. Kennedy, LPC

• Dermatology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.

Verify at the official NPI Registry.