Active NPI
Rebecca Dee Kennedy, CNP
- Psychiatric Hospital
- Saint Peter, MN
National Provider Identifier
1275975252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- R 132003-5
- Practice address
- 100 Freeman Dr
Saint Peter, MN 56082-3504 - Phone
- (507) 340-7650
- NPI assigned
- Jul 19, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | R 132003-5 | MN | Primary |
Addresses
Primary practice location
100 Freeman Dr
Saint Peter, MN 56082-3504
Mailing address
100 Freeman Dr
Saint Peter, MN 56082-3504
Phone (507) 340-7650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 132003-5 | MN | MD | Psychiatric Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374192000000",
"number": "1275975252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 FREEMAN DR",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560823504",
"telephone_number": "507-340-7650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 FREEMAN DR",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560823504",
"telephone_number": "507-340-7650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "REBECCA",
"middle_name": "DEE",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-19",
"last_updated": "2013-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "MN",
"license": "R 132003-5",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.