Todd Edward Kennedy, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103906 Issued in NC

Practice address

142 Sherlock Dr
Statesville, NC 28625-1953

Phone

(704) 838-8256

Fax

(704) 838-8251

NPI assigned

Aug 12, 2005

Last updated

Jul 17, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897
  NPD

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1720080393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277",
            "fax_number": "704-978-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SHERLOCK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251953",
            "telephone_number": "704-838-8256",
            "fax_number": "704-838-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "TODD",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Ault Kelly, PA-C
• Brittanie Kendrick
• Brandi Gallaher Kennedy, MD
• John Lowry Kennedy, PHARMACIST
• Stephanie Kennedy
• Rudy Max Ketchie, DMD
• Fayez Azir Khan, DDS
• Vichka Simon Khoy, PHARMD
• Kidney Care, P.C.
• Jennifer Leanne Kilby, CADC

• Physician Assistant in Statesville, NC
• Providers in Statesville, NC by specialty
• Physician Assistant in North Carolina

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

Verify at the official NPI Registry.