Active NPI
Sean Christopher Kenny
- Physician Assistant
- Aberdeen, SD
National Provider Identifier
1528031549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0470
- Practice address
- 2301 8TH Ave NE Ste 225
Aberdeen, SD 57401-3253 - Phone
- (605) 229-3510
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0470 | SD | Primary |
Addresses
Primary practice location
2301 8TH Ave NE Ste 225
Aberdeen, SD 57401-3253
Mailing address
2301 8TH Ave NE Ste 225
Aberdeen, SD 57401-3253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6823084 | Medicaid | SD |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0470 | SD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363305600000",
"number": "1528031549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 8TH AVE NE STE 225",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574013253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 8TH AVE NE STE 225",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574013253",
"telephone_number": "605-229-3510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNY",
"first_name": "SEAN",
"middle_name": "CHRISTOPHER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2013-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SD",
"license": "0470",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6823084",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.