Individual provider Active NPI

William Robert Kennedy, MD

  • Radiation Oncology Physician
  • Phoenix, AZ
National Provider Identifier
1720433766
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
62956 Issued in AZ
Practice address
350 W Thomas Rd
Bni Radiation Oncology
Phoenix, AZ 85013
Phone
(602) 406-6761
Fax
(602) 406-5515
NPI assigned
Apr 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 218421 NC
Radiation Oncology Physician 2085R0001X 62956 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
Bni Radiation Oncology
Phoenix, AZ 85013

Mailing address

350 W Thomas Rd
Bni Radiation Oncology
Phoenix, AZ 85013
Phone (602) 406-6761

Other practice location 1

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110-1003
Phone (336) 832-7272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210621001856 AZ Practitioner - Radiation Oncology 2567756570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

500 W Thomas Rd
680 DHMG St Joseph'S Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017

Hospital & facility affiliations

  • St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024
  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
218421NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Pathology Current Accepting new patients
St. Joseph'S Outpatient Surgery Center, LLC Current Accepting new patients
Sjhmc Physician Services CurrentSince Aug 1, 2021 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients

Locations

240 W Thomas Rd
Ste 301
Phoenix, AZ 85013
Phone (602) 406-6262

2910 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 406-3008

2910 N 3rd Ave
Ste 430
Phoenix, AZ 85013
Phone (602) 406-7421

2910 N 3rd Ave
#200
Phoenix, AZ 85013
Phone (602) 406-3008

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

File 56765
Los Angeles, CA 90074

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1720433766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "address_2": "BNI RADIATION ONCOLOGY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-6761",
            "fax_number": "602-406-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "address_2": "BNI RADIATION ONCOLOGY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-6761",
            "fax_number": "602-406-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "336-832-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "218421",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AZ",
            "license": "62956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.