John Wayne Kennedy, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01022780A Issued in IN

Practice address

1614 N Baldwin Ave
Marion, IN 46952-1437

Phone

(765) 664-9000

Fax

(765) 391-1521

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786233600000",
    "number": "1780665448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 N BALDWIN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469521437",
            "telephone_number": "765-664-9000",
            "fax_number": "765-391-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 N BALDWIN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469521437",
            "telephone_number": "765-664-9000",
            "fax_number": "765-391-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOHN",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2026-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01022780",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01022780A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000576122",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000697935",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100123680",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000286588",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Rae Keller, ATC/L
• Stephen Keller, M.D.
• Vincent D Kelley, PH.D.
• Donald Aaron Kellogg
• Stuart Glen Kelly, DDS
• Benjamin C Keplar, LCSW
• Edward L Keppler, M.D.
• Christopher M. Kerby, O.D.
• Kayla Marie Key, FNP-C
• Sirajabid Khatib, MD

• General Practice Physician in Marion, IN
• Providers in Marion, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.