Caroline Ruth Kennedy, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86264915 Issued in NY

Practice address

1001 Main St
Buffalo, NY 14203-1009

Phone

(716) 323-0030

NPI assigned

Sep 3, 2024

Last updated

Sep 3, 2024By the provider in NPPES

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

Enrolled in NY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• University at Buffalo Pediatric Associates Inc

  • Pediatrics Physician
  • Buffalo, NY
  • NPI 1912928599
  Medicare reassignment NPD
• University Gynecologists & Obstetricians,Inc.

  • Obstetrics & Gynecology Physician
  • Buffalo, NY
  • NPI 1154354140
  NPD (past)

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1558196436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 TRAILING DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217538",
            "telephone_number": "716-204-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CAROLINE",
        "middle_name": "RUTH",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86264915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenmore Qualitycare Dentistry, PC
• Kenmore Village Pharmacy, LLC.
• Kenmore-Town of Tonawanda Ufsd
• Alexis Rose Kennedy
• Amy Marie Kennedy, LPN
• Denise Lynn Kennedy, MSW
• Karley Renee McCarthy Kennedy
• Kimberly Kennedy
• Nathaniel Kennedy, RN
• Samantha June Kennedy, M.S.ED

• Registered Dietitian in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.