Individual provider Active NPI

Kennedy Smith

  • Student in an Organized Health Care Education/Training Program
  • Dubuque, IA
National Provider Identifier
1467274118
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2000 University Ave
Dubuque, IA 52001
Phone
(563) 589-3662
NPI assigned
Oct 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2000 University Ave
Dubuque, IA 52001

Mailing address

2000 University Ave
Dubuque, IA 52001
Phone (563) 589-3662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20260310004465 IA Practitioner - Physician Assistant 7113400953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians

Practice addresses (Care Compare)

1790 Blairs Ferry Rd
Hiawatha, IA 52233-2033
Phone (319) 378-8362

3701 Katz Dr
Marion, IA 52302-3871
Phone (319) 377-3174

Hospital & facility affiliations

  • Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Associates Inc CurrentSince Jan 20, 2026 Accepting new patients
Mercy Physician Associates, Inc CurrentSince Jan 20, 2026 Accepting new patients

Organizations & group practices 3

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 1

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": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1467274118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "52001",
            "telephone_number": "563-589-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "52001",
            "telephone_number": "563-589-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.