Individual provider Active NPI

Dennis Kenyon, M.D.

  • General Practice Physician
  • Springfield, MO
National Provider Identifier
1467433300
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
R8D26 Issued in MO
Practice address
2240 W Sunset St Ste 104
Springfield, MO 65807-6041
Phone
(417) 883-7500
Fax
(417) 269-9281
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R8D26 MO
General Practice Physician 208D00000X R8D26 MO Primary

Addresses

Primary practice location

2240 W Sunset St Ste 104
Springfield, MO 65807-6041

Mailing address

2240 W Sunset St Ste 104
Springfield, MO 65807-6041
Phone (417) 883-7500

Other practice location 1

121 Johnstown Dr
Rogersville, MO 65742-9366
Phone (417) 753-7757

Other identifiers 1

IdentifierTypeStateIssuer
202082517MedicaidMO

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040218001144 MO Practitioner - General PracticePractitioner - Emergency Medicine 6305731258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients
Faith Hospice of the Ozarks LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dennis.kenyon@cernerdirect.coxhealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1467433300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 W SUNSET ST STE 104",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076041",
            "telephone_number": "417-883-7500",
            "fax_number": "417-269-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 W SUNSET ST STE 104",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076041",
            "telephone_number": "417-883-7500",
            "fax_number": "417-269-9281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Johnstown Dr",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "MO",
            "postal_code": "657429366",
            "country_code": "US",
            "telephone_number": "417-753-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENYON",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R8D26",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "R8D26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202082517",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.