Individual provider Active NPI

Jenna L Kenney, PA-C

  • Medical Physician Assistant
  • Omaha, NE
National Provider Identifier
1659518744
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in NE
Practice address
4014 Leavenworth St
Omaha, NE 68105
Phone
(402) 559-5208
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PENDING NE Primary

Addresses

Primary practice location

4014 Leavenworth St
Omaha, NE 68105

Mailing address

4014 Leavenworth St
Omaha, NE 68105
Phone (402) 559-5208

Other names 1

  • Miss Jenna Linnae McTaggart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090317000518 NE Practitioner - Physician Assistant 7315004454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

3802 Raynor Pkwy
Bellevue, NE 68123-2504
Phone (402) 559-8600

4014 Leavenworth St
Omaha, NE 68105-1053
Phone (402) 552-7928

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGNEMDCertified Registered Nurse Anesthetist

Organizations & group practices 1

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 4

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": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1659518744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 LEAVENWORTH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68105",
            "telephone_number": "402-559-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LEAVENWORTH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68105",
            "telephone_number": "402-559-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JENNA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "MCTAGGART",
            "middle_name": "LINNAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.