Kelly Nicole Keniray, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.021986 Issued in OH

Practice address

211 15TH St NW
Canton, OH 44703-1704

Phone

(330) 450-0800

NPI assigned

Oct 31, 2017

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkeniraynp@littleflowerfp.medentdirect.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.

• Little Flower Family Practice

  • Family Medicine Physician
  • Canton, OH
  • NPI 1295955789
  Medicare reassignment NPD

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1427560440",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "629 47TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 15TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447031704",
            "telephone_number": "330-450-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENIRAY",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Madson Kemper Jr., D.P.M.
• Andrew Kendall, ED. S.
• Betsy L Kendis, M.D.
• Cory Kendrick
• Tina Keneaster, RPH
• Phillip Kennard Jr.
• Brandi N Kennedy, CDCA-PRE
• Leslie Dawn Kennedy
• Lynda J Kennedy, QMHS BA CM
• Courtney Kenworthy

• Family Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.