Stephen D Kennedy, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001650A Issued in IN

Practice address

5838 W Brick Rd Ste 106
South Bend, IN 46628

Phone

(574) 247-1911

Fax

(574) 247-1912

NPI assigned

Jul 15, 2005

Last updated

Feb 22, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Portage, MI
  • NPI 1669091864

  Single Specialty

  Medicare reassignment NPD
• Iah of Michigan, PLLC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Troy, MI
  • NPI 1578969705

  Single Specialty

  NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Troy, MI
  • NPI 1336153295

  Single Specialty

  NPD
• Methodist Medical Group Physicians Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1285673616

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1700885498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 W BRICK RD STE 106",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466288420",
            "telephone_number": "574-247-1911",
            "fax_number": "574-247-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 W BRICK RD STE 106",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46628",
            "telephone_number": "574-247-1911",
            "fax_number": "574-247-1912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Lincoln Way W",
            "address_2": "Suite O",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "IN",
            "postal_code": "465612062",
            "country_code": "US",
            "telephone_number": "574-674-6499",
            "fax_number": "574-674-6490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2725 Airview Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490021804",
            "country_code": "US",
            "telephone_number": "269-349-8386",
            "fax_number": "269-349-8397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013733",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001650A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200081840A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Starr E Kelly, O.T.
• Kathleen Kelsey, LCSW
• Brian Kemp
• Sydney Kempf
• Cailin Grace Kennedy, OTR/L
• Kathryn Anne Kenney, D.O., MBA
• Jena Ruth Kern, MD
• Nicholas Harold Kerr, DO
• Kristen Anne Kertesz, MA
• Alexa Rose Kessen, MD

• Family Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.