Kenedi Ellen Elizabeth Divine, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01096665A Issued in IN

Practice address

751 W 9TH St
Jasper, IN 47546-2609

Phone

(812) 996-7474

NPI assigned

Apr 15, 2022

Sex

Female

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 IN

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

Family Practice

Education

Indiana University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Deaconess Memorial Medical Center IncGroup PAC ID 4587578042, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Preferred Home Health Care, Inc Home health agency, Indianapolis, IN, CCN 157318
• Deaconess Home Health, LLC Home health agency, Evansville, IN, CCN 157565
• Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdivine18644@direct.mhhcc.org
• Direct secure messaging: kdivine1043278@direct.deaconess.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.

• Deaconess Memorial Medical Center Inc

  • Emergency Medicine Physician
  • Huntingburg, IN
  • NPI 1114120128

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585
  Medicare reassignment Care Compare group
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Family Medicine

  NPD
• Deaconess Clinic Inc.

  • Family Medicine Physician
  • Rockport, IN
  • NPI 1699921585
  NPD
• Deaconess Memorial Medical Center Inc

  • Pain Medicine Physician
  • Jasper, IN
  • NPI 1457164543
  NPD
• Deaconess Memorial Medical Center Inc

  • Internal Medicine Physician
  • Jasper, IN
  • NPI 1972516110
  NPD
• Deaconess Clinic, Inc

  • Rural Health Clinic/Center
  • Petersburg, IN
  • NPI 1831345792

  Family Medicine

  NPD (past)
• Deaconess Memorial Medical Center Inc

  • Pulmonary Disease Physician
  • Jasper, IN
  • NPI 1326123910
  NPD (past)

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

• Deaconess Home Health, LLC

  • Home Health Agency
  • Evansville, IN
  • NPI 1285285676
  Care Compare affiliation
• Deaconess Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Jasper, IN
  • NPI 1003895947
  Care Compare affiliation
• Preferred Home Health Care, Inc.

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1679562458
  Care Compare affiliation

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1275276560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462609",
            "telephone_number": "812-996-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462609",
            "telephone_number": "812-996-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINE",
        "first_name": "KENEDI",
        "middle_name": "ELLEN ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01096665A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael K Denu, LCSW
• Stephen Dewitt, D.O.
• Christopher R Dilger, PA-C
• Jenna R. Dilger, RD, CSP
• Braelyn Disney
• Ashton Rae Dixon, DO
• Lainie Rhiannon Donaldson
• Marrissa Doring, BCBA
• Lisa Dorsey, RN
• Angela Marie Douglas, RPH

• Family Medicine Physician in Jasper, IN
• Providers in Jasper, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.