Individual provider Active NPI

Katelyn Kenny

  • Registered Nurse
  • Newburyport, MA
National Provider Identifier
1740800838
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
072577-21 Issued in NH
Practice address
255 Low St Ste 202
Newburyport, MA 01950-3596
Phone
(978) 255-0378
NPI assigned
Apr 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 072577-21 NH Primary

Addresses

Primary practice location

255 Low St Ste 202
Newburyport, MA 01950-3596

Mailing address

255 Low St Ste 202
Newburyport, MA 01950-3596

Other practice location 1

155 Griffin Rd
Portsmouth, NH 03801-2093
Phone (603) 431-6011

Other practice location 2

61 Pleasant St Unit 757
Newburyport, MA 01950-1031
Phone (617) 665-7780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20240206003512 MA Practitioner - Nurse Practitioner 4587007646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
072577-21NHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Care Physicians, PC CurrentSince Dec 23, 2023 Accepting new patients
Cape Ann Medical Center LLC PastSince Nov 20, 2022 Accepting new patients

Locations

255 Low St
Ste 303
Newburyport, MA 01950
Phone (978) 225-0378

255 Low St
Ste 202
Newburyport, MA 01950
Phone (978) 225-0378

Interoperability endpoints

  • Direct secure messaging: katelyn.kenny.1@8421.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1740800838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 LOW ST STE 202",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LOW ST STE 202",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503596",
            "telephone_number": "978-255-0378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Griffin Rd",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038012093",
            "country_code": "US",
            "telephone_number": "603-431-6011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61 Pleasant St Unit 757",
            "address_purpose": "LOCATION",
            "city": "Newburyport",
            "state": "MA",
            "postal_code": "019501031",
            "country_code": "US",
            "telephone_number": "617-665-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNY",
        "first_name": "KATELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "072577-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.