Amanda Jill Kennedy

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

904484 Issued in MS

Practice address

50024 Robinson West Cir
Amory, MS 38821-8624

Phone

(662) 790-3700

Fax

(662) 257-0267

NPI assigned

May 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Merit-based Incentive Payment System (MIPS)

Final score

19.42 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

64.75

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Segue Health of Mississippi LLC

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1467989954
  Medicare reassignment NPD
• Mobile Wound Care Solutions LLC

  • Specialist
  • Cincinnati, OH
  • NPI 1548070014

  MS

  Medicare reassignment NPD
• Regional Healthcare Group LLC

  • Acute Care Nurse Practitioner
  • Mount Juliet, TN
  • NPI 1407587363

  MS

  Medicare reassignment NPD
• Guardian Biologics LLC

  • Specialist
  • Mount Juliet, TN
  • NPI 1033890876
  NPD

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

{
    "created_epoch": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620432000000",
    "number": "1740864446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50024 ROBINSON WEST CIR",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388218624",
            "telephone_number": "662-790-3700",
            "fax_number": "662-257-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50024 ROBINSON WEST CIR",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388218624",
            "telephone_number": "662-790-3700",
            "fax_number": "662-257-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "AMANDA",
        "middle_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-08",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "904484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy F Jaggers, FNP
• Amber James, PHARMD
• John Russell, III, D.M.D.
• Megan Johnson, MS, CCC-SLP
• Murial Teresa Johnson
• Korie Elizabeth Kent, DPT
• Alyson Rae Key, DPT
• Mary Ann King, D.O.
• Thomas Henry Kloor Jr., MD
• Justin Lee Knight, DPT

• Primary Care Clinic/Center in Amory, MS
• Providers in Amory, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; 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.