Individual provider Active NPI

David N Kenagy, MD

  • Pediatric Nephrology Physician
  • Danville, PA
National Provider Identifier
1316092554
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
MD451235 Issued in PA
Practice address
100 North Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-6440
Fax
(570) 271-6002
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 35056456 OH
Pediatric Nephrology Physician 2080P0210X C1-0012363 DE
Pediatric Nephrology Physician 2080P0210X MD451235 PA Primary

Addresses

Primary practice location

100 North Academy Ave
Danville, PA 17822-9800

Mailing address

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-5453

Other identifiers 7

IdentifierTypeStateIssuer
737885OtherOHBUCKEYE
000000546695OtherOHANTHEM
422455OtherOHWELLCARE
0709273MedicaidOH
000000229450OtherOHUNISON
1021092000001OtherPAPA MEDICAID
4112125OtherOHAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20140715000048 PA Practitioner - Pediatric MedicinePractitioner - Nephrology 4880643683 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35056456OHMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Family Medicine Current Accepting new patients
St. Luke'S Physician Group Inc. CurrentSince Sep 15, 2022 Accepting new patients
Nason Physician Practices LLC CurrentSince Aug 21, 2015 Accepting new patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Sep 15, 2022 Accepting new patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
Nason Physician Practices LLC Family Medicine CurrentSince Aug 21, 2015 Accepting new patients
Nason Physician Practices LLC Current Accepting new patients
Geisinger Clinic CurrentSince May 1, 2014 Accepting new patients
Geisinger Clinic Family Medicine CurrentSince May 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients
University Children'S Kidney Specialists, LLC Pediatric Nephrology Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

104 Hillcrest Dr
Roaring Spring, PA 16673
Phone (814) 224-5455

Interoperability endpoints

  • Direct secure messaging: dkenagy115858@direct.geisinger.edu
  • Direct secure messaging: dkenagy259958@ahs.direct-ci.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1316092554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6440",
            "fax_number": "570-271-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENAGY",
        "first_name": "DAVID",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "OH",
            "license": "35056456",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "DE",
            "license": "C1-0012363",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "PA",
            "license": "MD451235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "737885",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000546695",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "422455",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0709273",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000229450",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAID",
            "identifier": "1021092000001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4112125",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.