Active NPI
James Kennedy, M.D, PHD
- Plastic Surgery Physician
- Los Angeles, CA
National Provider Identifier
1730461690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- A118410
- Practice address
- 1510 San Pablo Street
Los Angeles, CA 90033-5324 - Phone
- (323) 442-7909
- Fax
- (323) 442-6020
- NPI assigned
- Sep 15, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | A118410 | CA | Primary |
Addresses
Primary practice location
1510 San Pablo Street
Los Angeles, CA 90033-5324
Mailing address
1510 San Pablo Street
Suite 514
Los Angeles, CA 90033-5324
Phone (323) 442-7909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A118410 | CA | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1730461690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1510 SAN PABLO STREET",
"address_2": "SUITE 514",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335324",
"telephone_number": "323-442-7909",
"fax_number": "323-442-6020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 SAN PABLO STREET",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335324",
"telephone_number": "323-442-7909",
"fax_number": "323-442-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-15",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "A118410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.