Individual provider Active NPI

Kathryn Mary Kendall, FNP

  • Family Nurse Practitioner
  • South Portland, ME
National Provider Identifier
1609159276
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP111063 Issued in ME
Practice address
51 Market St
South Portland, ME 04106-3617
Phone
(866) 389-2727
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN40707 ME
Family Nurse Practitioner 363LF0000X CNP111063 ME Primary

Addresses

Primary practice location

51 Market St
South Portland, ME 04106-3617

Mailing address

51 Market St
South Portland, ME 04106-3617
Phone (866) 389-2727

Other practice location 1

66 Water St
Wiscasset, ME 04578-4133
Phone (207) 882-6008

Other identifiers 1

IdentifierTypeStateIssuer
003386301OtherMEMEDICARE POVIDER IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: kathryn.kendall@wfm.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609159276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MARKET ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063617",
            "telephone_number": "866-389-2727",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MARKET ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063617",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Water St",
            "address_purpose": "LOCATION",
            "city": "Wiscasset",
            "state": "ME",
            "postal_code": "045784133",
            "country_code": "US",
            "telephone_number": "207-882-6008",
            "fax_number": "207-882-7803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "KATHRYN",
        "middle_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN40707",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP111063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE POVIDER IDENTIFICATION NUMBER",
            "identifier": "003386301",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.