Individual provider Active NPI

Katharyn E. Kennedy, MD

  • Emergency Medicine Physician
  • Marlborough, MA
National Provider Identifier
1487638326
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
150663 Issued in MA
Practice address
157 Union St
Department of Emergency Medicine
Marlborough, MA 01752-1228
Phone
(508) 421-1400
Fax
(508) 421-1490
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 150663 MA Primary

Addresses

Primary practice location

157 Union St
Department of Emergency Medicine
Marlborough, MA 01752-1228

Mailing address

67 N Quinsigamond Ave
Unit 15
Shrewsbury, MA 01545-5133

Other names 1

  • Taryn Kennedy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1487638326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 N QUINSIGAMOND AVE",
            "address_2": "UNIT 15",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015455133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 UNION ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521228",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATHARYN",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "150663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARYN",
            "last_name": "KENNEDY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.