Kennedy E McConnon, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

4704391552 Issued in MI

Practice address

3300 36TH St SE
Kentwood, MI 49512-2810

Phone

(616) 831-5547

NPI assigned

Nov 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

Other names 1

• Kennedy E Newberry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1306555784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 36TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495122810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 36TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495122810",
            "telephone_number": "616-831-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNON",
        "first_name": "KENNEDY",
        "middle_name": "E",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MI",
            "license": "4704391552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNEDY",
            "last_name": "NEWBERRY",
            "middle_name": "E",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ebony Monique McCauley
• Dakota McCaw
• Ronald T McClatchey, OD
• McColley Speech Services PLC
• Brandon Michael McColley, SLP
• Kevin McCormick, MD
• Datisia M McCoy
• Stacy Anita McGinnis, MSW
• Douglas Gene McKenzie, D.C.
• Thomas Joseph McNett-Tremblay

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.