Individual provider Active NPI

Mara Colleen Kennedy, DPM

  • Foot Surgery Podiatrist
  • Chillicothe, OH
National Provider Identifier
1629502950
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
36.004015 Issued in OH
Practice address
272 Hospital Rd
Chillicothe, OH 45601-9031
Phone
(740) 779-4598
NPI assigned
Apr 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 36.004015 OH Primary

Addresses

Primary practice location

272 Hospital Rd
Chillicothe, OH 45601-9031

Mailing address

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-4598

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.abjc@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813002498 OH Practitioner - Podiatry 9032513981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Aug 23, 2021 Accepting new patients

Locations

4437 State Route 159
Ste G15
Chillicothe, OH 45601
Phone (740) 779-8580

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

1000 Veterans Dr
Jackson, OH 45640
Phone (740) 395-8050

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1629502950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031",
            "telephone_number": "740-779-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031",
            "telephone_number": "740-779-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARA",
        "middle_name": "COLLEEN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OH",
            "license": "36.004015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.abjc@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.