Shawn Edward Kenney, DMSC, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07462 Issued in NC

Practice address

Naval Medical Readiness and Training Command
2080 Child Street
Jacksonville, FL 32214

Phone

(904) 542-7460

Fax

(904) 542-7835

NPI assigned

Feb 23, 2008

Last updated

Jan 30, 2025By the provider in NPPES

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1203724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1558530568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL READINESS AND TRAINING COMMAND",
            "address_2": "2080 CHILD STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32214",
            "telephone_number": "904-542-7460",
            "fax_number": "904-542-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL READINESS AND TRAINING COMMAND",
            "address_2": "2080 CHILD STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32214",
            "telephone_number": "904-542-7460",
            "fax_number": "904-542-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "SHAWN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-23",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khrisha Kenner
• Kathryn Rebecca Kennerly
• Kenneth W Jones M D P a
• Heidi Neal Kenney, MD
• Shaunagay Renay Kenney, PMHNP
• Lynnette Hansen Kennison, PMHCNS-BC
• Ann Kenny-Santoro, LCSW
• Caryn Beth Kenny, LCSW
• Joseph T Kenny, DPT
• Kenoir Solutions Inc

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.