Kathleen Dacuk Rose Kennedy, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024096751 Issued in VA

Practice address

1701 Thomson Dr
Lynchburg, VA 24501-1118

Phone

(434) 200-4010

Fax

(434) 200-7400

NPI assigned

Aug 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Central Virginia Family Physicians, Inc. Laboratory

  • Clinical Medical Laboratory
  • Lynchburg, VA
  • NPI 1083992523
  NPD (past)
• Rehabilitation Associates of Central Virginia, Inc.

  • Physical Therapist
  • Lynchburg, VA
  • NPI 1699727016
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1396754362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3017",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245030017",
            "telephone_number": "434-200-4010",
            "fax_number": "434-200-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-4010",
            "fax_number": "434-200-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATHLEEN",
        "middle_name": "DACUK ROSE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001096751",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024096751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7782951",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica B Keller, COTA
• Katie Hudson Kelley
• KC Kelley, DO
• Marie Gayle Kelly, DO
• David Ian Kendall
• Kimberly H. Kennedy, NP
• Sarah Kennedy, OTR/L
• Summer Joy Kennedy
• Tre'John R Kennedy
• Eric R Kenny, MD

• Nurse Practitioner in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.