Katherine Edithe Kennedy, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0818 Issued in AZ

Practice address

1728 W Glendale Ave Ste 100
Phoenix, AZ 85021-8862

Phone

(480) 812-3668

Fax

(480) 782-1290

NPI assigned

Oct 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foot Ankle Specialty Centers, LLCGroup PAC ID 7517058381, 7 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Foot Ankle Specialty Centers, LLC

  • Foot & Ankle Surgery Podiatrist
  • Gilbert, AZ
  • NPI 1679603724

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1350691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1316290893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 W GLENDALE AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218862",
            "telephone_number": "480-812-3668",
            "fax_number": "480-782-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 W GLENDALE AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218862",
            "telephone_number": "480-812-3668",
            "fax_number": "480-782-1290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 W Division St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606222717",
            "country_code": "US",
            "telephone_number": "312-770-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATHERINE",
        "middle_name": "EDITHE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-20",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135.000790",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z179475",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "footankleaz@aol.com",
            "affiliation": "N",
            "address_1": "1728 W Glendale Ave Ste 100",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850218862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ethan Owen Kennedy, DO
• Hannah Kennedy, LAC
• Jane Kennedy, MT
• Jean Kennedy, R.N.
• Karen Leslie Kennedy, M.D.
• Matthew Kennedy
• Maxwell L Kennedy
• Rena Kennedy
• Shannon Eileen Kennedy, DC
• Stephanie Kennedy, LMSW

• Foot & Ankle Surgery Podiatrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.