James Nicholas Kenny Jr., M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036072378 Issued in IL

Practice address

200 E Pennsylvania Ave
Suite 201
Peoria, IL 61603-3089

Phone

(309) 655-7700

Fax

(309) 624-8790

NPI assigned

Dec 1, 2005

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1427032515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "STE 530B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025007",
            "telephone_number": "309-655-7700",
            "fax_number": "309-624-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PENNSYLVANIA AVE",
            "address_2": "SUITE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033089",
            "telephone_number": "309-655-7700",
            "fax_number": "309-624-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "JAMES",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036072378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072378",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany M Kennedy, SLP
• Leandre Kennedy, DPM
• Valerie Gail Kennedy, OTR/L
• Kelly Ann Kennell, M.D.
• Kenneth D. Meiss D.M.D. LTD.
• Joshua Bradley Kentosh, D.O.
• Danielle Marie Keowen, OTR
• Cara Nicole Keplar, LCSW
• Kern Optometric Associates PC
• Dustin Kern

• Urology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.