Donald E Kennedy, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS0004552 Issued in FL

Practice address

2450 Tamiami TRL
Port Charlotte, FL 33952-3922

Phone

(941) 624-2704

Fax

(941) 627-6066

NPI assigned

Nov 23, 2005

Last updated

Dec 4, 2017By the provider in NPPES

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Spinal Health and Rehab of Punta Gorda

  • Sports Medicine (Internal Medicine) Physician
  • Punta Gorda, FL
  • NPI 1184946691
  Medicare reassignment NPD

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1447233408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 OLD MOULTRIE RD",
            "address_2": "STE 2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864198",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339523922",
            "telephone_number": "941-624-2704",
            "fax_number": "941-627-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DONALD",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0004552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BC",
            "identifier": "82515",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Andrew Kellenberger, PA, RD
• Janet Kelley
• Venda Kelley, ARNP
• Marcella Kelly, CRNP
• Shelby Kelly, PT
• Diturije Kerimi
• Anthony Kesner, LMFT
• Shauna Kessler, ARNP
• Sakina Khalidi, M.D.
• Asjad U Khan, MD

• Family Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.