NPIMap

Individual provider Active NPI

Jessica Lynn Kennedy, NP

  • Family Nurse Practitioner
  • Waupaca, WI
National Provider Identifier
1528797255
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12117 Issued in WI
Practice address
800 Riverside Dr
Waupaca, WI 54981-1943
Phone
(715) 258-1000
NPI assigned
Jun 8, 2022
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12117 WI Primary
Family Nurse Practitioner 363LF0000X APRN4162 HI

Addresses

Primary practice location

800 Riverside Dr
Waupaca, WI 54981-1943

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900

Other practice location 1

100 County Road B
Shawano, WI 54166-7072
Phone (715) 526-2111

Other practice location 2

16-523 Keaau Pahoa Rd
Keaau, HI 96749-8156
Phone (808) 932-3830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220829003265 WI Practitioner - Nurse Practitioner 5698159358 Reassigns benefits to 16 organizations
I20240918003177 HI Practitioner - Nurse Practitioner 5698159358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

16 -523 Keaau Pahoa Rd
Keaau, HI 96749-8156
Phone (808) 932-3830

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN4162HIMDFamily Nurse Practitioner
12117WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Medical Center - Wild Rose, Inc CurrentSince Jan 1, 2026 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jul 25, 2022 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Kau Hospital CurrentSince Aug 1, 2024 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Flambeau Hospital Inc CurrentSince Jul 25, 2022 Accepting new patients
Kau Hospital CurrentSince Aug 1, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Memorial Hospital Inc CurrentSince Jul 25, 2022 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - New London, Inc CurrentSince Jan 1, 2026 Accepting new patients
Flambeau Hospital Inc CurrentSince Jul 25, 2022 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 10, 2026 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
MCHS Hospitals Inc Current Accepting new patients

Locations

16-523 Keaau Pahoa Rd
Keaau, HI 96749
Phone (808) 932-3801

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1050 Division St
Mauston, WI 53948
Phone (608) 847-6161

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

601 Grove Ave
Wild Rose, WI 54984
Phone (920) 622-3257

Interoperability endpoints

  • Direct secure messaging: jessica.kennedy@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1528797255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811943",
            "telephone_number": "715-258-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 County Road B",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541667072",
            "country_code": "US",
            "telephone_number": "715-526-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16-523 Keaau Pahoa Rd",
            "address_purpose": "LOCATION",
            "city": "Keaau",
            "state": "HI",
            "postal_code": "967498156",
            "country_code": "US",
            "telephone_number": "808-932-3830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "12117",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN4162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

Verify at the official NPI Registry.