Cort Chedwin Kennedy MD PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CORT CHEDWIN KENNEDY MD PLLC

Practice address

229 Railroad Ave Ste 3
Sayville, NY 11782-2719

Phone

(631) 507-2979

NPI assigned

Jun 7, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Cort Chedwin Kennedy II, MDNPI 1730719659

Title

Owner

Phone

(631) 507-2979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cort Chedwin Kennedy II, MD

  • Family Medicine Physician
  • Sayville, NY
  • NPI 1730719659
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1447092853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 VANDERBILT BLVD",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117692038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 RAILROAD AVE STE 3",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822719",
            "telephone_number": "631-507-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORT CHEDWIN KENNEDY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CORT",
        "authorized_official_middle_name": "CHEDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-507-2979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Sayville, NY
• Providers in Sayville, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.