NPIMap

Individual provider Active NPI

Mary L. Kennedy, D.O.

  • Family Medicine Physician
  • Webb City, MO
National Provider Identifier
1659312841
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2001016563 Issued in MO
Practice address
6151 N Main Street Rd
Webb City, MO 64870-8189
Phone
(417) 781-0408
Fax
(417) 556-5377
NPI assigned
Jun 9, 2006
Last updated
Mar 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2001016563 MO Primary

Addresses

Primary practice location

6151 N Main Street Rd
Webb City, MO 64870-8189

Mailing address

6151 N Main Street Rd
Webb City, MO 64870-8189
Phone (417) 781-0408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000344 MO Practitioner - Family Practice 8426001579 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524

1717 S Range Line Rd B
Joplin, MO 64804-3224

6151 N Main St Rd
Webb City, MO 64870-8189
Phone (417) 781-0408

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001016563MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Carthage Current Accepting new patients
Mercy Clinic Joplin LLC Family Medicine CurrentSince Nov 1, 2009 Accepting new patients
Mercy Southern Missouri Ambulatory Services LLC CurrentSince May 1, 2023 Accepting new patients
Sjmgroup Past Accepting new patients
Alliance Radiology, PA PastSince May 1, 2023 Accepting new patients
Lincoln County Hospital Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1421 S Range Line Rd
Ste C
Joplin, MO 64801
Phone (417) 434-9445

3126 S Jackson Ave
Joplin, MO 64804
Phone (417) 782-1600

2150 W Republic Rd
Ste 112
Springfield, MO 65807
Phone (417) 986-1291

6151 N Main Street Rd
Webb City, MO 64870
Phone (417) 556-5350

Interoperability endpoints

  • Direct secure messaging: mkennedy190709@directb.mercy.net
  • Direct secure messaging: mkennedy200166@directc.mercy.net

Organizations & group practices 6

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1659312841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6151 N MAIN STREET RD",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648708189",
            "telephone_number": "417-781-0408",
            "fax_number": "417-556-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6151 N MAIN STREET RD",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648708189",
            "telephone_number": "417-781-0408",
            "fax_number": "417-556-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARY",
        "middle_name": "L.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001016563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webb City, MO

Sources for this page

Verify at the official NPI Registry.