Ann Marie Kennedy, RADT-1

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

330013AN Issued in CA

Practice address

17270 Roosevelt St
Riverside, CA 92508-9523

Phone

(951) 780-2541

Fax

(951) 780-5809

NPI assigned

Feb 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mfi Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
  • NPI 1881059525
  NPD (past)

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1679011027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042037",
            "telephone_number": "951-780-2541",
            "fax_number": "951-780-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17270 ROOSEVELT ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089523",
            "telephone_number": "951-780-2541",
            "fax_number": "951-780-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "RADT-1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "330013AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Valentine Keltner, O.D.
• Susan Kelvie
• Delashawn Yavonne Kemp, LMFT
• Krissy Kendrick, SLPA
• Lorna Kendrick, PHD
• Brittany Kennedy
• Jasmine Marian Kennedy
• Mallory Adele Kennedy, O.D.
• Regina Kennedy, LMFT
• Kenneth C Browning, D.O., a Professional Corporation

• Case Manager/Care Coordinator in Riverside, CA
• Providers in Riverside, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.