Betty J Kennedy, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

009626 Issued in ME

Practice address

106 Campus Ave
Lewiston, ME 04240-6019

Phone

(207) 755-3383

Fax

(207) 755-3285

NPI assigned

Jul 10, 2006

Last updated

Jul 11, 2011By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Community Clinical Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ME
  • NPI 1629851761
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1316971716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1638",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011638",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CAMPUS AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406019",
            "telephone_number": "207-755-3383",
            "fax_number": "207-755-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BETTY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "009626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290100099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Kelsen, FNP-BC
• Sally Jo Holt Kelsey, REGISTERED NURSE
• Katherine A Kemp
• Roberta Kemper
• Lee G Kendall Jr., MD
• Joyce P Kennedy, O.T.
• Bruce Kenney
• Nicole Jean Kenney
• Rachel Anne Kerner, D.O.
• Katherine Kessler, D.O.

• Internal Medicine Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.