Jane E Kennedy, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

13881 Issued in CA

Practice address

2455 Bennett Valley Rd Ste B205
Santa Rosa, CA 95404-5667

Phone

(707) 536-9722

Fax

(707) 843-5475

NPI assigned

Apr 24, 2007

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

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679792071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 BENNETT VALLEY RD STE B205",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045667",
            "telephone_number": "707-536-9722",
            "fax_number": "707-843-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 BENNETT VALLEY RD STE B205",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045667",
            "telephone_number": "707-536-9722",
            "fax_number": "707-843-5475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26800 Crown Valley Pkwy",
            "address_2": "Suite #435",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916384",
            "country_code": "US",
            "telephone_number": "949-542-3838",
            "fax_number": "949-542-3839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JANE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "13881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Michael Kendall
• Joy Kendall, MFT
• Robert M Kennedy Galindo
• Dennis Kennedy, O.D., FAAO
• Eleanna Alexia Kennedy
• Kimberly Anne Kennedy
• Ron Kennedy, M.D.
• Kenne William Kennemer, MFT
• Kyrie Kennemore
• Kenneth J. Bauer, DDS, a Professional Corporation

• Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.