Denise A Kennedy, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

36609-20 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54301-3505

Phone

(920) 433-3653

NPI assigned

Jun 6, 2006

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

Other names 1

• Dorothy Denise Abbott Kennedy Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pathology Consultants of Green Bay SCGroup PAC ID 5395737019, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Bellin Health Oconto Hospital Hospital, Oconto, WI, CCN 521356

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkennedymd6281@direct.froedtert.com

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.

• Pathology Consultants of Green Bay, S.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Green Bay, WI
  • NPI 1710938352
  Medicare reassignment Care Compare group
• Froedtert Manitowoc Medical Group, LLC

  dba Froedtert Northeast Medical Group

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment NPD
• Ameripath Milwaukee SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Beaver Dam, WI
  • NPI 1356321715
  NPD (past)

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

• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation
• Oconto Hospital & Medical Center Inc

  dba Emplify Health Oconto Hospital

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1407896962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E WASHINGTON ST",
            "address_2": "P O BOX 8031",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115490",
            "telephone_number": "800-236-1489",
            "fax_number": "920-739-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DENISE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "36609-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32121400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHY DENISE",
            "last_name": "KENNEDY",
            "middle_name": "ABBOTT",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ken Sann (Independent Assessment & Counseling Services)
• Kimberly Kendall, PT
• Kayce Kendziorski
• Shannon Lee Wyman Kenevan
• Dana Lynn Kennedy, RD
• Kimberly Kennedy, LPC
• Stephanie Kennedy, RN
• Timothy J Kennedy, MD
• Kenneth C. Clark DDS,Ms
• Kenneth C. Sturgis DC SC

• Anatomic Pathology & Clinical Pathology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.

Verify at the official NPI Registry.