Individual provider Active NPI

Jessica Lynn Kennedy, RN

  • Infection Control Registered Nurse
  • Summerville, SC
National Provider Identifier
1699410381
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infection Control Registered NurseTaxonomy code 163WI0600X
License
245896 Issued in SC
Practice address
520 Beverly Dr
Summerville, SC 29485-8191
Phone
(803) 213-9628
NPI assigned
Apr 28, 2022
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infection Control Registered Nurse 163WI0600X 245896 SC Primary

Addresses

Primary practice location

520 Beverly Dr
Summerville, SC 29485-8191

Mailing address

520 Beverly Dr
Summerville, SC 29485-8191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
245896SCMDInfection Control Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1699410381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 BEVERLY DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 BEVERLY DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858191",
            "telephone_number": "803-213-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infection Control",
            "state": "SC",
            "license": "245896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.