Active NPI
Michael S. Kennedy, MD
- Family Medicine Physician
- Lindon, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4994501-1205
- Practice address
- 275 W 200 N
Suite 204
Lindon, UT 84042-5009 - Phone
- (801) 796-1333
- Fax
- (801) 796-0625
- NPI assigned
- Oct 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4994501-1205 | UT | Primary |
Addresses
Primary practice location
275 W 200 N
Suite 204
Lindon, UT 84042-5009
Mailing address
275 W 200 N
Suite 204
Lindon, UT 84042-5009
Phone (801) 796-1333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- 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
- Family Practice
- Education
- Michigan State University College of Human Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
226 N 1100
American Fork, UT 84003-2054
Phone (801) 855-3841
275 W 200
Lindon, UT 84042-5009
Phone (801) 796-1333
830 N 2000
Pleasant Grove, UT 84062-4047
Phone (801) 756-3511
Hospital & facility affiliations
- Intermountain Health Utah Valley Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4994501-1205 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Family Medical | Family Medicine | Current | Accepting new patients |
| Premier Family Medical - City Center | Family Medicine | Current | Accepting new patients |
Locations
226 N 1100 E
American Fork, UT 84003
Phone (801) 855-3840
3943 E Pony Express Pkwy
Ste 120
Eagle Mountain, UT 84005
Phone (801) 443-1184
3000 N Triumph Blvd
Ste 220
Lehi, UT 84043
Phone (801) 642-2990
680 E Main St
Lehi, UT 84043
Phone (801) 766-0606
275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333
275 W 200 N
Ste 204
Lindon, UT 84042
Phone (801) 769-2565
830 N 2000 W
Pleasant Grv, UT 84062
Phone (801) 756-3511
62 E Thrive Dr
Ste 100
Saratoga Springs, UT 84045
Phone (801) 766-8427
1528 N Commerce Dr
Ste 204
Saratoga Springs, UT 84045
707 E Mill Rd
Ste 303
Vineyard, UT 84059
Phone (801) 224-1300
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Pleasant Grove, UT
- NPI 1750725735
-
- Family Medicine Physician
- Eagle Mountain, UT
- NPI 1649160235
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1417047010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 W 200 N",
"address_2": "SUITE 204",
"city": "LINDON",
"state": "UT",
"postal_code": "840425009",
"telephone_number": "801-796-1333",
"fax_number": "801-796-0625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W 200 N",
"address_2": "SUITE 204",
"city": "LINDON",
"state": "UT",
"postal_code": "840425009",
"telephone_number": "801-796-1333",
"fax_number": "801-796-0625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MICHAEL",
"middle_name": "S.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "4994501-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lindon, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.