Active NPI
Colin Kennedy, M.D.
- Surgery Physician
- Winona, MN
National Provider Identifier
1346772159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 72299
- Practice address
- 855 Mankato Ave
Winona, MN 55987-4868 - Phone
- (507) 454-3650
- NPI assigned
- Mar 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | 72299 | MN | Primary |
Addresses
Primary practice location
855 Mankato Ave
Winona, MN 55987-4868
Mailing address
PO Box 725
Cooperstown, NY 13326-0725
Other practice location 1
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Wisconsin School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650
Hospital & facility affiliations
- Winona Health Services
- Gundersen Lutheran Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 32 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 21 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winona Health Services | Current | Accepting new patients |
Locations
855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680
Interoperability endpoints
- ckennedy316083@bassett.direct-ci.net
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Winona, MN
- NPI 1295789352
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winona, MN
- NPI 1295789352
-
- General Acute Care Hospital
- La Crosse, WI
- NPI 1376593442
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1346772159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 725",
"city": "COOPERSTOWN",
"state": "NY",
"postal_code": "133260725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 MANKATO AVE",
"city": "WINONA",
"state": "MN",
"postal_code": "559874868",
"telephone_number": "507-454-3650"
}
],
"practiceLocations": [
{
"address_1": "1 Atwell Rd",
"address_purpose": "LOCATION",
"city": "Cooperstown",
"state": "NY",
"postal_code": "133261301",
"country_code": "US",
"telephone_number": "607-547-3456",
"fax_number": "607-547-6612",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENNEDY",
"first_name": "COLIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-30",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "72299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.