Active NPI
L Thomas Kenney, MD
- Pediatrics Physician
- Lafayette, IN
National Provider Identifier
1790761534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35030307
- Practice address
- 1716 Hartford St
Lafayette, IN 47904-2173 - Phone
- (765) 742-1567
- Fax
- (765) 429-2700
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35030307 | OH | Primary |
Addresses
Primary practice location
1716 Hartford St
Lafayette, IN 47904-2173
Mailing address
1716 Hartford St
Lafayette, IN 47904-2173
Phone (765) 742-1567
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410666 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35030307 | OH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1790761534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 HARTFORD ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042173",
"telephone_number": "765-742-1567",
"fax_number": "765-429-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 HARTFORD ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042173",
"telephone_number": "765-742-1567",
"fax_number": "765-429-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEY",
"first_name": "L",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35030307",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "410666",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.