Nicole Dyan Kennedy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2841 Issued in CO

Practice address

850 East Harvard Avenue
Suite 285
Denver, CO 80210

Phone

(303) 777-3333

Fax

(303) 733-4441

NPI assigned

Sep 8, 2009

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 names 1

• Ms. Nicole Dyan Jacobs Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rocky Mountain Kidney Care LLCGroup PAC ID 5597170969, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Ridge Medical Center Hospital, Lone Tree, CO, CCN 060112

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nicole.kennedy.1@19427.direct.athenahealth.com

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.

• Rocky Mountain Kidney Care LLC

  • Nephrology Physician
  • Lone Tree, CO
  • NPI 1861082117
  Medicare reassignment Care Compare group
• Kidney Associates of Colorado

  • Nephrology Physician
  • Denver, CO
  • NPI 1699961979
  Medicare reassignment
• Well Nourished LLC

  • Adult Mental Health Clinic/Center
  • Golden, CO
  • NPI 1598409468
  Medicare reassignment
• Transtreme, LLC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1003290453
  NPD (past)

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

• HCA Healthone LLC

  • General Acute Care Hospital
  • Lone Tree, CO
  • NPI 1659325629
  Care Compare affiliation

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1730412958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 EAST HARVARD AVENUE",
            "address_2": "SUITE 285",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80210",
            "telephone_number": "303-777-3333",
            "fax_number": "303-733-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 EAST HARVARD AVENUE",
            "address_2": "SUITE 285",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80210",
            "telephone_number": "303-777-3333",
            "fax_number": "303-733-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "NICOLE",
        "middle_name": "DYAN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "JACOBS",
            "middle_name": "DYAN",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Kennedy
• Lisa T Kennedy
• Mary Kay Kennedy, MSW LCSW
• Megan Pamela Kennedy, AUD
• Nathan Kennedy, D.C.
• Sean Kennedy, DPM
• Susan Kennedy
• Timothy C Kennedy, MD
• Whitney S Kennedy, M.D.
• Terrell Kennet

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.