Rose J Kenny, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD23253 Issued in OR

Practice address

1001 NW Canal Blvd Ste 101
Redmond, OR 97756-1697

Phone

(541) 548-8088

Fax

(541) 548-8018

NPI assigned

Sep 29, 2008

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Impact Physician Group, LLC

  • Internal Medicine Physician
  • Peachtree City, GA
  • NPI 1114428612

  OR

  Medicare reassignment NPD
• Family Care Center PC

  • Family Medicine Physician
  • Redmond, OR
  • NPI 1508832411
  Authorized official Same address or phone

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194975037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NW CANAL BLVD STE 101",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561697",
            "telephone_number": "541-548-8088",
            "fax_number": "541-548-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NW CANAL BLVD STE 101",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561697",
            "telephone_number": "541-548-8088",
            "fax_number": "541-548-8018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 NW Canal Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977561697",
            "country_code": "US",
            "telephone_number": "541-548-8088",
            "fax_number": "541-548-8018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNY",
        "first_name": "ROSE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD23253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228793",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Kellogg, PA
• Emily Kelly
• Nicole C Kelly
• Timothy L Kelly, MD
• Lisa Kennedy
• Lorelei Kern
• Anne C Killingbeck, M.D.
• Jimmy Kim, L.AC.
• Denise Kimball
• Matthew Robert Kinback, PT, DPT

• Family Medicine Physician in Redmond, OR
• Providers in Redmond, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.