Individual provider Active NPI

Christopher James Kennedy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Detroit, MI
National Provider Identifier
1437503885
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901400389 Issued in MI
Practice address
4201 Saint Antoine St # 9C
Detroit, MI 48201-2153
Phone
(313) 745-4698
NPI assigned
Apr 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X 5901400389 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St # 9C
Detroit, MI 48201-2153

Mailing address

560 W Mitchell St
Ste 560
Petoskey, MI 49770-2279
Phone (231) 487-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021003281 MI Practitioner - Podiatry 5991098907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

560 W Mitchell St
Suite 300
Petoskey, MI 49770-2278
Phone (231) 487-2460

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue36
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan Multi-Specialty CurrentSince Oct 15, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Oct 15, 2020 Accepting new patients
McLaren Central Michigan Multi-Specialty Current Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

560 W Mitchell St
Ste 300
Petoskey, MI 49770
Phone (231) 487-2460

560 W Mitchell St
Ste 560
Petoskey, MI 49770
Phone (231) 487-2150

560 W Mitchell St
Ste 160
Petoskey, MI 49770
Phone (231) 487-3118

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1437503885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "STE 560",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702279",
            "telephone_number": "231-487-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAMES",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901400389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.