NPIMap

Individual provider Active NPI

Diane L Kennedy, M.D.

  • Family Medicine Physician
  • Luverne, MN
National Provider Identifier
1316939721
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34864 Issued in MN
Practice address
1601 Sioux Valley Drive
Luverne, MN 56156
Phone
(507) 283-4476
Fax
(507) 283-9086
NPI assigned
Aug 22, 2005
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34864 MN Primary

Addresses

Primary practice location

1601 Sioux Valley Drive
Luverne, MN 56156

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9556

Other identifiers 1

IdentifierTypeStateIssuer
332090100MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dkennedy6963@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100122000115 MN Practitioner - Family PracticePractitioner - Emergency Medicine 1951443498 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Minnesota Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health NetworkGroup PAC ID 6800707100, shared by 49 NPIs, 357 clinicians

Practice addresses (Care Compare)

1018 6TH Ave
Worthington, MN 56187-2202
Phone (507) 372-3800

1601 Sioux Valley Dr
Luverne, MN 56156-4500
Phone (507) 283-4476

201 Maine Ave
Adrian, MN 56110-1214
Phone (507) 483-2668

733 Main St
Suite a
Edgerton, MN 56128-3000
Phone (507) 631-4476

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
80.98
Promoting interoperability
100
Improvement activities
40
Cost
70.78

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34864MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Family Medicine CurrentSince Oct 26, 2022 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Health Network Current Accepting new patients
Sanford Health Network Family Medicine Current Accepting new patients
Sanford Clinic Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Parkview Manor Nursing Home Past Accepting new patients

Locations

104 Buncombe Dr
Rock Rapids, IA 51246
Phone (712) 472-3333

118 N 7th Ave
Sheldon, IA 51201
Phone (712) 324-5041

601 Louisiana Ave
Adrian, MN 56110
Phone (507) 483-2668

1600 N Kniss Ave
Luverne, MN 56156
Phone (507) 283-2321

1601 Sioux Valley Dr
Luverne, MN 56156
Phone (507) 283-4476

450 Eastvold Ave
Ortonville, MN 56278
Phone (320) 839-2502

249 5th St E
Tracy, MN 56175
Phone (507) 629-3520

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Good Samaritan Society - PipestonePipestone, MN, CCN 245591 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 24, 2024
Jun 24, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1316939721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9556",
            "fax_number": "605-328-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SIOUX VALLEY DRIVE",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "56156",
            "telephone_number": "507-283-4476",
            "fax_number": "507-283-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "34864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332090100",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkennedy6963@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1601 Sioux Valley Drive",
            "city": "Luverne",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Luverne, MN

Sources for this page

Verify at the official NPI Registry.