Active NPI
Roger Lee Kennedy Jr., PHARM.D.
- Pharmacist
- Tuscumbia, AL
National Provider Identifier
1417296104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16809
- Practice address
- 1404 E Avalon Ave
Tuscumbia, AL 35674-1773 - Phone
- (256) 389-9800
- NPI assigned
- Jan 31, 2013
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16809 | AL | Primary |
Addresses
Primary practice location
1404 E Avalon Ave
Tuscumbia, AL 35674-1773
Mailing address
1404 E Avalon Ave
Tuscumbia, AL 35674-1773
Phone (256) 389-9800
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16809 | AL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennedy LLC | Current | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Tuscumbia, AL
- NPI 1174869622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1417296104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 E AVALON AVE",
"city": "TUSCUMBIA",
"state": "AL",
"postal_code": "356741773",
"telephone_number": "256-389-9800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 E AVALON AVE",
"city": "TUSCUMBIA",
"state": "AL",
"postal_code": "356741773",
"telephone_number": "256-389-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ROGER",
"middle_name": "LEE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-31",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "16809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscumbia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.