Nicole Kennedy, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5855 Issued in OR

Practice address

5253 NE Sandy Blvd
Portland, OR 97213-2562

Phone

(503) 893-5131

NPI assigned

Dec 13, 2017

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

Other names 1

• Ms. Nicole Pease Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Wellness Group, LLC

  • Clinic/Center
  • Forest Grove, OR
  • NPI 1962909531
  NPD (past) Authorized official
• Cascade Spine & Injury Center, LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1326369398
  NPD

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1487169371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25365 NW MORELAND RD",
            "city": "NORTH PLAINS",
            "state": "OR",
            "postal_code": "971339206",
            "telephone_number": "971-232-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132562",
            "telephone_number": "503-893-5131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25365 NW Moreland Rd",
            "address_purpose": "LOCATION",
            "city": "North Plains",
            "state": "OR",
            "postal_code": "971339206",
            "country_code": "US",
            "telephone_number": "971-232-1566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3307 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Grove",
            "state": "OR",
            "postal_code": "971161909",
            "country_code": "US",
            "telephone_number": "503-389-2248",
            "fax_number": "503-433-1831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PEASE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katrina L Kennedy
• Keyona M Kennedy, CD
• Lindsey Nields Kennedy, BA, CADC I, HTR
• Mallory Kennedy
• Megan Kennedy, NP
• Pfeiffer M Kennedy
• Rebecca H. Kennedy, MD
• Rebecca Jean Kennedy, MST, RKT
• Shannon C Kennedy
• Sharon D Kennedy, NP

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.