Individual provider Active NPI

Joseph Kennell, PHD

  • Psychologist
  • Parkersburg, WV
National Provider Identifier
1649305988
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
557 Issued in WV
Practice address
3705 Emerson Ave
Parkersburg, WV 26104-1118
Phone
(304) 865-0272
Fax
(304) 865-0265
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 557 WV Primary

Addresses

Primary practice location

3705 Emerson Ave
Parkersburg, WV 26104-1118

Mailing address

3705 Emerson Ave
Parkersburg, WV 26104-1118
Phone (304) 865-0272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20070618000177 WV Practitioner - Clinical Psychologist 1355440231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4138 Williams Hwy
Williamstown, WV 26187-8397
Phone (304) 375-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Kennell PHD Psychologist CurrentSince Aug 15, 2014 Accepting new patients
David M Schaffer MSW Licsw PLLC PastSince Aug 15, 2014 Accepting new patients

Locations

3705 Emerson Ave
Parkersburg, WV 26104
Phone (304) 865-0272

4138 Williams Hwy
Williamstown, WV 26187
Phone (304) 375-8800

100 Wood Duck Ln
Williamstown, WV 26187
Phone (304) 375-8800

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1649305988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 EMERSON AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041118",
            "telephone_number": "304-865-0272",
            "fax_number": "304-865-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 EMERSON AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041118",
            "telephone_number": "304-865-0272",
            "fax_number": "304-865-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELL",
        "first_name": "JOSEPH",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.