Jordan Nicole Kennon, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.011301 Issued in IL

Practice address

1717 6TH Ave S
Birmingham, AL 35233-1801

Phone

(205) 934-3454

NPI assigned

Dec 8, 2023

Last updated

Jun 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baal Perazim Wellness IncGroup PAC ID 7618218587, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21150/brand/1/csg/1/fhir/r4

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.

• Baal Perazim Wellness, Inc

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1215403530
  Medicare reassignment Care Compare group NPD
• Baal Perazim Wellness, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1114547247
  NPD (past)

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1629845763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 1ST AVE S APT 651",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331863",
            "telephone_number": "505-353-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801",
            "telephone_number": "205-934-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNON",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011301",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Irving Kennell Jr., MD
• Kenneth Mark Middlebrooks MD PC
• Kenneth R. Smith, P.C. (Ophthalmology Associates)
• Kenneth Obiefuna Kenneth-Nwosa, MD
• Hailey Ann Kennett, RN
• Heather H Kent, CRNA
• Katherine Kent
• Kayla Kent
• Leigh Kent, DDS, PHD
• Mary Margaret Kent

• Clinical Psychologist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.