Mark Allen Kennedy

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0067444 Issued in CO

Practice address

2351 G Rd
Grand Junction, CO 81505-9641

Phone

(512) 413-9888

NPI assigned

Mar 20, 2019

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

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.kennedy.1@8363.direct.athenahealth.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.

• Colorado West Healthcare System

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1497723407

  Family Medicine

  NPD (past)
• Community Medical Group, LLC

  • Family Medicine Physician
  • Grand Junction, CO
  • NPI 1629201637
  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1245790948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 BENCHMARK ST",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786264530",
            "telephone_number": "512-413-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 G RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "512-413-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0067444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leisel Maria Kemp, B.A.
• Glenn Ross Kempeers, MD
• Barbara L Kennedy, LCSW
• James Michael Kennedy, D.D.S.
• Jennifer Elizabeth Kennedy, MD
• Kenneth C. Lewis MD,LLC
• Kenneth C. Lewis MD,LLC
• Kelsey Lee Kerton, D.O.
• Bradley Robert Kessler
• Ketamine Infusion Specialists

• Internal Medicine Physician in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.