Jennifer Rose Kenny

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801094494 Issued in MI

Practice address

715 Pyle Dr
Kingsford, MI 49802-4456

Phone

(906) 774-0522

Fax

(906) 774-1570

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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.

• Clark County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Neillsville, WI
  • NPI 1598986564

  WI

  Medicare reassignment NPD
• Clark County

  • Skilled Nursing Facility
  • Owen, WI
  • NPI 1497812697
  NPD

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 16, 2012.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1730278367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024456",
            "telephone_number": "906-774-0522",
            "fax_number": "906-774-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024456",
            "telephone_number": "906-774-0522",
            "fax_number": "906-774-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "JW085768",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Johnson, LBSW
• Paul Henry Johnson, MSW
• Jessica Ac Judy, NP-C
• Kirsten L Kaad, D.D.S.
• Stephen Arthur Kaad, D.D.S.
• Karen Lynn Kirschner
• Amy Beth Kleikamp, PTA
• Evan Kleikamp
• Laura Marie Knoll
• Ryan James Krog, D.C.

• All providers in Kingsford, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.