Susanne Michelle Kennedy

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

58967 Business Center Dr
Suites C,D
Yucca Valley, CA 92284-7308

Phone

(760) 369-3130

Fax

(760) 365-2695

NPI assigned

May 4, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1497101844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58967 BUSINESS CENTER DR",
            "address_2": "SUITES C,D",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847308",
            "telephone_number": "760-369-3130",
            "fax_number": "760-365-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58967 BUSINESS CENTER DR",
            "address_2": "SUITES C,D",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847308",
            "telephone_number": "760-369-3130",
            "fax_number": "760-365-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SUSANNE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harlan M Kartchner
• Andre Martin Kasko, D.O.
• Leea Kasten
• Jasdeep Kaur
• Quincy M Kennedy
• Samantha Kerkenides, RN
• Tamara Kilduff
• Dae Yong Kim, MD
• Elizabeth Ann Kirkland, B.S.
• Carrie Kish

• Community Health Worker in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.