Michael Dee Kennedy, ARNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

ARNP9206905 Issued in FL

Practice address

3120 Southride Lane
Bonifay, FL 32425

Phone

(850) 547-4440

Fax

(850) 547-4441

NPI assigned

Aug 25, 2008

Last updated

Aug 14, 2024By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holmes County Hospital CorpGroup PAC ID 3375557887, shared by 2 NPIs, 21 clinicians

Northwest Florida Healthcare, Inc.Group PAC ID 2668363771, shared by 8 NPIs, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doctors Memorial Hospital Hospital, Bonifay, FL, CCN 101307

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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.

• Holmes County Hospital Corp

  dba Doctors Memorial Hospital

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Medicare reassignment NPD
• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708
  Medicare reassignment NPD
• Hawkins Family Medicine LLC

  • Family Medicine Physician
  • Bonifay, FL
  • NPI 1952680464
  Medicare reassignment
• Holmes County Hospital Corp

  dba Bonifay Rural Health Clinic

  • Rural Health Clinic/Center
  • Bonifay, FL
  • NPI 1952917015
  NPD
• Northwest Florida Healthcare, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Chipley, FL
  • NPI 1659438760
  NPD
• The Pathology Group of Northwest Florida PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1114153269
  NPD
• Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1760738611
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holmes County Hospital Corp

  dba Doctors Memorial Hospital

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Care Compare affiliation

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1235386004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BRICKYARD RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286303",
            "telephone_number": "850-638-1610",
            "fax_number": "850-415-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 SOUTHRIDE LANE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "32425",
            "telephone_number": "850-547-4440",
            "fax_number": "850-547-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2910 Hospital Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Bonifay",
            "state": "FL",
            "postal_code": "324254268",
            "country_code": "US",
            "telephone_number": "850-547-8118",
            "fax_number": "850-547-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MICHAEL",
        "middle_name": "DEE",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9206905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "ARNP9206905",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y129U",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000636200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Bonifay, FL
• Providers in Bonifay, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.