Active NPI
Kathleen S. Kenney, N.P.
- Nurse Practitioner
- Dorchester Center, MA
National Provider Identifier
1386738250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 151095
- Practice address
- 2100 Dorchester Ave
Dorchester Center, MA 02124-5615 - Phone
- (617) 296-4000
- Fax
- (617) 474-3856
- NPI assigned
- Oct 3, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 151095 | MA | Primary |
Addresses
Primary practice location
2100 Dorchester Ave
Dorchester Center, MA 02124-5615
Mailing address
36 Trident Ave
Winthrop, MA 02152-1206
Phone (617) 846-3101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0357235 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 151095 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carney Medical Group | Past | Accepting new patients | |
| Bickford Health Associates, PC | Past | Accepting new patients | |
| Boston Medical Group, PC | Past | Accepting new patients | |
| Southeast Anesthesia Assoc | Past | Accepting new patients |
Organizations & group practices 4
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.
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- NPI 1538101191
-
- Specialist
- Brighton, MA
- NPI 1326142704
-
- Anesthesiology Physician
- Dorchester Center, MA
- NPI 1891780078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386738250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 TRIDENT AVE",
"city": "WINTHROP",
"state": "MA",
"postal_code": "021521206",
"telephone_number": "617-846-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 DORCHESTER AVE",
"city": "DORCHESTER CENTER",
"state": "MA",
"postal_code": "021245615",
"telephone_number": "617-296-4000",
"fax_number": "617-474-3856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEY",
"first_name": "KATHLEEN",
"middle_name": "S.",
"name_prefix": "Miss",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "151095",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0357235",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dorchester Center, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.