Individual provider Active NPI

Robert Adam Kennard, BA, CDCA, CPRS

  • Peer Specialist
  • Cincinnati, OH
National Provider Identifier
1619697695
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
5122 Glencrossing Way
Cincinnati, OH 45238-3361
Phone
(513) 827-9044
NPI assigned
Aug 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.185458 OH

Addresses

Primary practice location

5122 Glencrossing Way
Cincinnati, OH 45238-3361

Mailing address

2909 Carr St
Ashland, KY 41102-5504
Phone (606) 471-5732

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)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CDCA.185458OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Treatment Centers Oh-VI, LLC PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1619697695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 CARR ST",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411025504",
            "telephone_number": "606-471-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 GLENCROSSING WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383361",
            "telephone_number": "513-827-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNARD",
        "first_name": "ROBERT",
        "middle_name": "ADAM",
        "credential": "BA, CDCA, CPRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.185458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.