Stephen William Kennedy, MD

Primary specialty

Bone Densitometry Radiologic TechnologistTaxonomy code 2471B0102X

License

A86061 Issued in CA

Practice address

9300 W Stockton Blvd
Ste 104
Elk Grove, CA 95758-8070

Phone

(916) 691-2069

Fax

(916) 691-2065

NPI assigned

Sep 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Stephen Kennedy, MD, Inc.

  • Diagnostic Radiology Physician
  • Elk Grove, CA
  • NPI 1629188941
  NPD (past) Authorized official

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1689668279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 W STOCKTON BLVD",
            "address_2": "STE 104",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588070",
            "telephone_number": "916-691-2069",
            "fax_number": "916-691-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 W STOCKTON BLVD",
            "address_2": "STE 104",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588070",
            "telephone_number": "916-691-2069",
            "fax_number": "916-691-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471B0102X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Bone Densitometry",
            "state": "CA",
            "license": "A86061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI - ORGANIZATION",
            "identifier": "1629188941",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatiana Simone Kelley, MD
• Kelly P Couch DDS Inc
• Michael F. Kelly, MD
• Durrell Kendrick
• Nonyelum Nneka Kendricks
• Jessica Deann Kenny, ASW
• Abigail Kertelli
• Nicole Louise Kesler, LMFT, MA
• Kirsten Kessler
• Savoy Key

• Radiologic Technologist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.