Kenneth Russell Kennedy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H2504 Issued in TX

Practice address

1221 McKinney St
Houston, TX 77010-2011

Phone

(713) 442-4700

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Interoperability endpoints

• Direct secure messaging: kkennedy2190@direct.kelsey-seybold.com

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.

• Kelsey-Seybold Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Family Medicine

  Medicare reassignment NPD
• Four Hands Surgical Assistant Co.

  • Preferred Provider Organization
  • Houston, TX
  • NPI 1043496557
  NPD (past)
• Village Chiropractic and Wellness P.L.L.C.

  • Chiropractor
  • League City, TX
  • NPI 1972750719
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1235225517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MCKINNEY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770102011",
            "telephone_number": "713-442-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KENNETH",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H2504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104745801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1221 McKinney St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770102011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkennedy2190@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1221 McKinney St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770102011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dyann Renee Kennedy, LMT
• James W Kennedy, D.D.S.
• Jennifer Anjeanette Kennedy
• Joshua Kennedy
• Kathleen A Kennedy, M.D.
• Lakisha Kennedy
• Lilac N Kennedy, M.A.,BCBA
• Lindsay Kennedy, PT, DPT
• Luke Kennedy, MD
• Mackenzie Kennedy

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.