NPIMap

Individual provider Active NPI

Clara J Kennedy, PA-C

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1437339496
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
732 Issued in NE
Practice address
7100 W Center Rd
Omaha, NE 68106-2700
Phone
(402) 506-9110
Fax
(402) 965-0722
NPI assigned
Nov 7, 2007
Last updated
Aug 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 732 NE Primary

Addresses

Primary practice location

7100 W Center Rd
Omaha, NE 68106-2700

Mailing address

7100 W Center Rd
Omaha, NE 68106-2700
Phone (402) 506-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080205000686 NE Practitioner - Physician Assistant 3476455247 Reassigns benefits to 1 organization
I20241114004501 SD Practitioner - Physician Assistant 3476455247 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
City of BrookingsGroup PAC ID 1052307105, 112 clinicians
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

203 N Elk St
Elkton, SD 57026-2103
Phone (605) 542-7701

212 N Prairie St
Flandreau, SD 57028-1243

214 N Prairie St
Flandreau, SD 57028-1243
Phone (605) 997-2433

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 692-6351

400 22ND Ave
Brookings, SD 57006-2450
Phone (605) 697-9500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.04 of 100Reported as apm
Quality
89.99
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.11 of 100Reported as group
Quality
89.93
Promoting interoperability
100
Improvement activities
40
Cost
54.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
732NEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jan 5, 2025 Accepting new patients
City of Brookings Current Accepting new patients
Avera McKennan CurrentSince Sep 10, 2025 Accepting new patients
Rural Health Care, Inc CurrentSince Nov 11, 2024 Accepting new patients
Avera McKennan CurrentSince Jan 5, 2025 Accepting new patients
City of Brookings CurrentSince Nov 11, 2024 Accepting new patients
Avera McKennan Past Accepting new patients
Rural Health Care, Inc. Past Accepting new patients
Rosebud Indian Health Service Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

400 22nd Ave
Ste 1
Brookings, SD 57006
Phone (605) 697-9500

Interoperability endpoints

  • Direct secure messaging: carla.kennedy@avera.sdhealthlink.net

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1437339496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062700",
            "telephone_number": "402-506-9110",
            "fax_number": "402-965-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062700",
            "telephone_number": "402-506-9110",
            "fax_number": "402-965-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CLARA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.