Individual provider Active NPI

Markus Kennedy

  • Durable Medical Equipment & Medical Supplies
  • Sacramento, CA
National Provider Identifier
1760875736
Registry record updated Mar 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
1215 K St
Sacramento, CA 95814-3945
Phone
(916) 289-1269
NPI assigned
Mar 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X CA Primary

Addresses

Primary practice location

1215 K St
Sacramento, CA 95814-3945

Mailing address

1215 K St
Sacramento, CA 95814-3945
Phone (916) 289-1269

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426291200000",
    "number": "1760875736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 K ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958143945",
            "telephone_number": "916-289-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 K ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958143945",
            "telephone_number": "916-289-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARKUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.