Christy L Kennedy, PHLEBOTOMY MANAGER

Primary specialty

Blood Banking Specialist/TechnologistTaxonomy code 246QB0000X

License

603 Issued in WA

Practice address

11320 N Parksmith Dr
Mead, WA 99021-9501

Phone

(509) 703-2202

NPI assigned

Jun 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1639748957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11320 N PARKSMITH DR",
            "city": "MEAD",
            "state": "WA",
            "postal_code": "990219501",
            "telephone_number": "509-703-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11320 N PARKSMITH DR",
            "city": "MEAD",
            "state": "WA",
            "postal_code": "990219501",
            "telephone_number": "509-703-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PHLEBOTOMY MANAGER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "WA",
            "license": "60346851",
            "primary": false
        },
        {
            "code": "246Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Pathology",
            "state": "WA",
            "license": "60346851",
            "primary": false
        },
        {
            "code": "246QB0000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Blood Banking",
            "state": "WA",
            "license": "60346851",
            "primary": false
        },
        {
            "code": "246QB0000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Blood Banking",
            "state": "WA",
            "license": "603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASST PHLEBOTOMY AND NATIONAL PHLEBOTOMY",
            "identifier": "60346851",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mead Adult Family Home, LLC

• All providers in Mead, WA
• Blood Banking Specialist/Technologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.