Willard Lee Kennedy, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

20149 Issued in NC

Practice address

3324 Six Forks Rd
Raleigh, NC 27609-7233

Phone

(919) 781-7772

Fax

(919) 787-6331

NPI assigned

Jul 20, 2005

Last updated

Mar 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Carolina Cardiology Consultants, PA

  • Specialist
  • Raleigh, NC
  • NPI 1336130178
  NPD
• Rex Hospital, Inc.

  dba Rex Nutrition Services

  • Nutrition Education Nutritionist
  • Raleigh, NC
  • NPI 1821472572
  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
  • NPI 1013203819
  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians

  • Surgery Physician
  • Raleigh, NC
  • NPI 1396791786
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1649279696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3324 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097233",
            "telephone_number": "919-781-7772",
            "fax_number": "919-787-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3324 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097233",
            "telephone_number": "919-781-7772",
            "fax_number": "919-787-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "WILLARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "20149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8948497",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lianne Kennedy, FNP
• Mary Sloan Kennedy, CRNA
• Susan Lucille Kennedy, M.D.
• Taylor Kennedy
• Toqui Veronique Kennedy, MA, LPA
• Marsha Moore Kenner, RD, LDN
• Kenneth Banks MD PA (Kenneth Banks MD)
• Lauren Ann Kenney, LCSWA
• Casey Kenny
• Julia Elizabeth Anne Kenny, FNP

• Cardiovascular Disease Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.