Active NPI
Andrew Ryan Kennedy, PHARM.D.
- Pharmacist
- Chadron, NE
National Provider Identifier
1649748161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16864
- Practice address
- 510 Linden St
Chadron, NE 69337-6989 - Phone
- (308) 432-6995
- NPI assigned
- Nov 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21054 | CO | |
| Pharmacist | 183500000X | 16864 | NE | Primary |
Addresses
Primary practice location
510 Linden St
Chadron, NE 69337-6989
Mailing address
510 Linden St
Chadron, NE 69337-6989
Phone (308) 432-6995
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21054 | Other | CO | STATE BOARD OF PHARMACY |
| 16864 | Other | NE | NEBRASKA BOARD OF PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21054 | CO | MD | Pharmacist |
| 16864 | NE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Chadron, NE
- NPI 1699792796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635033600000",
"number": "1649748161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 LINDEN ST",
"city": "CHADRON",
"state": "NE",
"postal_code": "693376989",
"telephone_number": "308-432-6995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 LINDEN ST",
"city": "CHADRON",
"state": "NE",
"postal_code": "693376989",
"telephone_number": "308-432-6995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ANDREW",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-02",
"last_updated": "2021-10-24",
"certification_date": "2021-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "21054",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "16864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE BOARD OF PHARMACY",
"identifier": "21054",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEBRASKA BOARD OF PHARMACY",
"identifier": "16864",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chadron, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.