KD Medicine & Wellness PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

KD MEDICINE & WELLNESS PLLC

Practice address

565 Turnpike St Ste 71
North Andover, MA 01845-5936

Phone

(508) 641-0235

NPI assigned

Jun 7, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth R Dovidio, PA-C,MHPNPI 1891812061

Title

Physician Assistant

Phone

(508) 641-0235

Specialties & licenses 3

Addresses

Other names 1

• KD Medicine & Wellness Former legal business name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24138/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth R Dovidio, PA

  • Physician Assistant
  • North Andover, MA
  • NPI 1891812061
  Medicare reassignment Authorized official
• Anita S Dovidio, DMD

  • General Practice Dentistry
  • Billerica, MA
  • NPI 1578646980
  NPD (past)

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1669049995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 TURNPIKE ST STE 71",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455936",
            "telephone_number": "508-641-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 TURNPIKE ST STE 71",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455936",
            "telephone_number": "508-641-0235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Turnpike St Ste 204",
            "address_purpose": "LOCATION",
            "city": "North Andover",
            "state": "MA",
            "postal_code": "018456156",
            "country_code": "US",
            "telephone_number": "508-641-0235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KD MEDICINE & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "DOVIDIO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "508-641-0235",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C,MHP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KD Medicine & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KD Medicine & Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "KD Medicine & Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Prerana Karki, NP
• Elizabeth Marie Kashian
• Meghan Marie Kasper
• Diana Appell Kassler, M.ED., C.A.G.S.
• Kate Brien Nutrition Counseling, LLC
• Laurie Keegan, CNP
• Jennifer Suzanne Keeler, MS, CCC/SLP
• Tracy Anne Keen
• Amy Kehoe, LMHC
• Robyn E Keleher, MSW, LICSW

• Physician Assistant in North Andover, MA
• Providers in North Andover, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.