Jan Marie Kennedy, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1076407 Issued in AL

Practice address

1813 Beltline Rd SW
Decatur, AL 35601-5506

Phone

(256) 353-6874

Fax

(256) 260-0594

NPI assigned

May 10, 2006

Last updated

Aug 17, 2010By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1730139098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5689",
            "address_2": "1813 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356010689",
            "telephone_number": "256-353-6874",
            "fax_number": "256-260-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015506",
            "telephone_number": "256-353-6874",
            "fax_number": "256-260-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JAN",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1076407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51533376",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA LICENSE",
            "identifier": "1-076407",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Keenum, OTR/L
• Sabra L Keenum, LPC, MA
• Jeanette N Keith, MD
• Kelli Wright Counseling, LLC
• Kelly Young
• Mary Kathleen Kennedy
• Rachel E. Kennedy, D.O.
• Sarah E Kennedy
• Kevin D Campbell CRNP PC
• James Warren Kicker Jr., RPH. (PHARMACIST)

• Family Nurse Practitioner in Decatur, AL
• Providers in Decatur, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.