Kaleb Marion Leo Pat Kenneaster, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16031A Issued in WY

Practice address

525 E Market St
Akron, OH 44304-1619

Phone

(330) 375-3584

NPI assigned

Mar 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WY

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

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cheyenne Regional Physicians Group LLCGroup PAC ID 2961403639, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eden Home Health Home health agency, Cheyenne, WY, CCN 537836
• Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkenneaster59792@direct.crmcwy.org

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.

• Cheyenne Regional Physicians Group, LLC

  • Medical Oncology Physician
  • Cheyenne, WY
  • NPI 1659458008

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Cheyenne Children'S Clinic, PC

  • Pediatrics Physician
  • Cheyenne, WY
  • NPI 1073537601
  NPD (past)

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

• Eden Home Health of Cheyenne, LLC

  • Home Health Agency
  • Cheyenne, WY
  • NPI 1497428338
  Care Compare affiliation
• Memorial Hospital of Laramie County

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Care Compare affiliation

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1295363083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619",
            "telephone_number": "330-375-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619",
            "telephone_number": "330-375-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEASTER",
        "first_name": "KALEB",
        "middle_name": "MARION LEO PAT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "16031A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkenneaster59792@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Cheyenne Regional Physicians Group, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkenneaster59792@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Cheyenne Regional Physicians Group, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monica Marie Kenley
• Kenmore Dental Group, Jeffrey S. Rosenthal D.D.S., Inc.
• Diane Lee Kenna
• Jonathan Lance Kenna, CDCA
• McKayla Kennard, LAY MIDWIFE
• Chelsea Kennedy-Snodgrass
• Brittany Kennedy
• Gretchen Kennedy, P.T.
• Kathleen Joyce Kennedy, RPH
• O'Liva Kennedy, B.A., QMHS

• Family Medicine Physician in Akron, OH
• Providers in Akron, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.