Michael J Kennedy D.C., P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

4999 Issued in MN

Legal business name

MICHAEL J KENNEDY D.C., P.A.

Practice address

6409 City West Parkway
Suite 105
Eden Prairie, MN 55344

Phone

(952) 833-3038

NPI assigned

Dec 19, 2007

Last updated

Dec 19, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael John Kennedy, D.C.NPI 1639358088

Title

President/Vice-President/Treasurer

Phone

(612) 387-5864

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael John Kennedy, D.C.

  • Chiropractor
  • Plymouth, MN
  • NPI 1639358088
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1518141027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 41ST AVE NORTH",
            "address_2": "APT 118",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "612-387-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6409 CITY WEST PARKWAY",
            "address_2": "SUITE 105",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-833-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J KENNEDY D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/VICE-PRESIDENT/TREASURER",
        "authorized_official_telephone_number": "612-387-5864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": "4999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole A Meyer, PT
• Katie Lynn Meyers
• Marie Meysembourg
• Elizabeth Meza Hernandez
• MH Health Care Services, PC
• Jamie Michels
• Midwest Center for Emdr Training
• Midwest Chiropractic and Wellness
• Midwest Chiropractic and Wellness Center P.a. (Midwest Chiropractic and Wellness P.A.)
• Madisen Mikiska, LPCC

• Primary Care Clinic/Center in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Primary Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.