Individual provider Active NPI

Grace Ruth Kennedy, DO

  • Pulmonary Disease Physician
  • Tulsa, OK
National Provider Identifier
1568478071
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2837 Issued in OK
Practice address
7307 S Yale Ave
Suite 101
Tulsa, OK 74136-7049
Phone
(918) 710-2062
Fax
(918) 392-4552
NPI assigned
Aug 1, 2006
Last updated
Dec 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 2837 OK Primary

Addresses

Primary practice location

7307 S Yale Ave
Suite 101
Tulsa, OK 74136-7049

Mailing address

7307 S Yale Ave
Ste. 101
Tulsa, OK 74136-7049
Phone (918) 710-2062

Other identifiers 1

IdentifierTypeStateIssuer
100088740AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100430000031 OK Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0840227716 Reassigns benefits to 1 organization
I20200916002528 KS Practitioner - Pulmonary Disease 0840227716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Oklahoma State University College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

1027 E Cherry St
Cushing, OK 74023-4101
Phone (918) 225-2915

10512 N 110TH E Ave
Suite 130
Owasso, OK 74055-6636
Phone (918) 376-8149

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-9393

1202 N Muskogee PL
Claremore, OK 74017-3058
Phone (918) 341-2556

1245 S Utica Ave
Tulsa, OK 74104-4214

1731 N 90TH St
Select Specialty Hospital Kansas City
Kansas City, KS 66112-1515
Phone (913) 732-5900

20 E 34TH St
Sand Springs, OK 74063-4001
Phone (918) 245-9675

2401 W Main St
Henryetta, OK 74437-3893
Phone (918) 652-9650

2403 W Main St
Henryetta, OK 74437-3893
Phone (918) 652-9650

4408 S Harvard Ave
Tulsa, OK 74135-2615
Phone (918) 574-0350

8801 S 101St E Ave
Tulsa, OK 74133-5716
Phone (918) 294-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2837OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Select Specialty Hospital - Kansas City, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Select Specialty Hospital - Kansas City Inc CurrentSince Aug 1, 2020 Accepting new patients
Ahs Oklahoma Physician Group LLC CurrentSince Jan 1, 2018 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Jan 1, 2018 Accepting new patients
Asthma and Respiratory Consultants PA Pulmonary Disease Past Accepting new patients
Family Medical Care of Tulsa Inc Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

1731 N 90th St
Kansas City, KS 66112
Phone (913) 732-5900

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1120 S Utica Ave
Rm 3207
Tulsa, OK 74104

1245 S Utica Ave
Tulsa, OK 74104
Phone (918) 560-3823

1245 S Utica Ave
Ste 302
Tulsa, OK 74104
Phone (918) 382-2560

Dept 1206
Tulsa, OK 74182

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Interoperability endpoints

  • Direct secure messaging: gkennedy137886@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1568478071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7307 S YALE AVE",
            "address_2": "STE. 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367049",
            "telephone_number": "918-710-2062",
            "fax_number": "918-392-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7307 S YALE AVE",
            "address_2": "SUITE 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367049",
            "telephone_number": "918-710-2062",
            "fax_number": "918-392-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GRACE",
        "middle_name": "RUTH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OK",
            "license": "2837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088740A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.