Individual provider Active NPI

Geneva Noelle Kennedy, WHNP

  • Women's Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1790233765
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
N95005449 Issued in CA
Practice address
7695 Cardinal CT Ste 240
San Diego, CA 92123-3357
Phone
(858) 277-9378
Fax
(858) 277-9370
NPI assigned
Sep 19, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN2303029 MA
Registered Nurse 163W00000X RN2303029 MA
Registered Nurse 163W00000X 95102883 CA
Women's Health Nurse Practitioner 363LW0102X NPF95005449 CA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NP95005449 MA
Women's Health Nurse Practitioner 363LW0102X N95005449 CA Primary

Addresses

Primary practice location

7695 Cardinal CT Ste 240
San Diego, CA 92123-3357

Mailing address

18 Robert St
Apartment 6
Roslindale, MA 02131-2539
Phone (858) 705-3139

Other names 1

  • Miss Geneva Noelle Knuth Former name

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
I20170220002702 MA Practitioner - Nurse Practitioner 9436432317 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95102883CAMDRegistered Nurse
N95005449CAMDWomen's Health Nurse Practitioner
NPF95005449CAMDWomen's Health Nurse Practitioner
RN2303029MAMDWomen's Health Nurse Practitioner
NP95005449MAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 25, 2019 Accepting new patients
Pratt OB/GYN Associates, Inc CurrentSince Dec 20, 2016 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 25, 2019 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 25, 2019 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 25, 2019 Accepting new patients
Atrius Health, Inc. CurrentSince Apr 1, 2021 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790233765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ROBERT ST",
            "address_2": "APARTMENT 6",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312539",
            "telephone_number": "858-705-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7695 CARDINAL CT STE 240",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233357",
            "telephone_number": "858-277-9378",
            "fax_number": "858-277-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GENEVA",
        "middle_name": "NOELLE",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2303029",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2303029",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95102883",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NPF95005449",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MA",
            "license": "NP95005449",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "N95005449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEVA",
            "last_name": "KNUTH",
            "middle_name": "NOELLE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.