William J Kennedy, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DO28974 Issued in OR

Practice address

6410 NE Halsey St
Ste 300
Portland, OR 97213-4742

Phone

(503) 215-4691

Fax

(503) 215-4846

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1467431452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 NE HALSEY ST",
            "address_2": "STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134742",
            "telephone_number": "503-215-4691",
            "fax_number": "503-215-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A10208",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A10208",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO28974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500609867",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Jean Kennedy, MST, RKT
• Shannon C Kennedy
• Sharon D Kennedy, NP
• Shiletha Kennedy
• Terence Kennedy
• Thomas M Kennefick, MD
• Alice Da Palma Kennerly
• Kenneth Crandell, D.C.
• Kailin Kenney
• Karee Kenney, M.S.P.T.

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.