Kennedy Behavioral Health Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KENNEDY BEHAVIORAL HEALTH CENTER, LLC

Practice address

2420 Terry Rd
Jackson, MS 39204-5754

Phone

(601) 597-4979

NPI assigned

Nov 2, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Kennedy

Title

President

Phone

(601) 597-4979

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1568835387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 DOLOROSO LOOP RD",
            "city": "WOODVILLE",
            "state": "MS",
            "postal_code": "396693805",
            "telephone_number": "601-597-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 TERRY RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392045754",
            "telephone_number": "601-597-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY BEHAVIORAL HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-597-4979",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine T Kency, M.D.
• Barbara Kendrick
• Carly Kendrick
• Daryl Kendrick, ATC-L, CSCS
• Jennifer Lashelle Kennard, D.O.
• Carol Anne Kennedy, PHARMD
• Charles Reggie Kennedy Sr., CERTIFIED ORTHOTIST
• Daniel Kennedy, M.D.
• Daniel Davis Kennedy, MD
• John L Kennedy Jr., M.D.

• Community/Behavioral Health Agency in Jackson, MS
• Providers in Jackson, MS by specialty
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.