Active NPI
Michael S Kennedy, M.D.
- Allergy & Immunology Physician
- Everett, WA
National Provider Identifier
1740224658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- MD00014525
- Practice address
- 3901 Hoyt Ave
Everett, WA 98201 - Phone
- (425) 339-5412
- Fax
- (425) 259-1164
- NPI assigned
- Jun 15, 2006
- Last updated
- Mar 7, 2019
- 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 |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD00014525 | WA | Primary |
Addresses
Primary practice location
3901 Hoyt Ave
Everett, WA 98201
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (425) 339-5412
Other practice location 1
4540 Sand Point Way NE
Suite 200
Seattle, WA 98105-3941
Phone (206) 527-1200
Other practice location 2
4540 Sand Point Way NE
Suite 200
Seattle, WA 98105-3941
Phone (206) 527-1200
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030002415 | Other | WA | RAILROAD MEDICARE |
| 030004279 | Other | WA | RAILROAD MEDICARE |
| 1005750 | Medicaid | WA | |
| KE7883 | Other | WA | REGENCE |
| 111120483 | Other | WA | MEDICARE |
| 030004268 | Other | WA | MEDICARE RAILROAD |
| 120835 | Other | WA | CIGNA DMERC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00014525 | WA | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Hospital & Regional Medical Center 2 | Past | Accepting new patients | |
| Northwest Asthma & Allergy Center | Allergy & Immunology | Past | Accepting new patients |
| Northwest Asthma & Allergy Center | Allergy & Immunology | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/26116/brand/1/csg/1/fhir/r4
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Children's Hospital
- Seattle, WA
- NPI 1083789630
-
- Allergy & Immunology Physician
- Richland, WA
- NPI 1154496537
-
- Allergy & Immunology Physician
- Mount Vernon, WA
- NPI 1255406617
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1740224658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "425-339-5412",
"fax_number": "425-259-1164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 HOYT AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "98201",
"telephone_number": "425-339-5412",
"fax_number": "425-259-1164"
}
],
"practiceLocations": [
{
"address_1": "4540 Sand Point Way NE",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981053941",
"country_code": "US",
"telephone_number": "206-527-1200",
"fax_number": "206-523-0724",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4540 Sand Point Way NE",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981053941",
"country_code": "US",
"telephone_number": "206-527-1200",
"fax_number": "206-523-0724",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENNEDY",
"first_name": "MICHAEL",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "WA",
"license": "MD00014525",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "030002415",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "030004279",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1005750",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "KE7883",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "111120483",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "030004268",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DMERC",
"identifier": "120835",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.