Kayla Nicole Kennedy, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

22 Pine St
Suite 104
Bristol, CT 06010-6948

Phone

(860) 584-8291

NPI assigned

Jun 8, 2016

Last updated

Jun 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kayla.kennedy.1@1323.direct.athenahealth.com

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.

• Hartford Healthcare Medical Group, Inc

  dba Hartford HealthCare Medical Group

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301
  Medicare reassignment NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment
• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD
• WRK Ventures, LLC

  dba Urgent Care of Southbury

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1467801605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MOHAWK ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061911",
            "telephone_number": "203-560-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 104",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "860-584-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KAYLA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Elliot Kaye
• Jeffrey Kaye, M.D.
• Kelly Badyrka, LPC, LLC
• Emily Kelly
• Shane Patrick Kelly, PHARM.D.
• Kenneth K. Rhee, MD,PC
• Mia Kercado, LDO
• Khaula Khatlani, M.D.
• Ponita Khouy, RD
• Sapna Khubchandani, M.D.

• Medical Physician Assistant in Bristol, CT
• Providers in Bristol, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.