Individual provider Active NPI

Lynn A. Kennedy, CNM, DNP

  • Advanced Practice Midwife
  • Reno, NV
National Provider Identifier
1790894426
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN001758 Issued in NV
Practice address
975 Ryland St Ste 105
Reno, NV 89502-1668
Phone
(775) 982-5640
Fax
(775) 982-5641
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 094968 AZ
Advanced Practice Midwife 367A00000X APRN001758 NV Primary

Addresses

Primary practice location

975 Ryland St Ste 105
Reno, NV 89502-1668

Mailing address

780 Kuenzli St Ste 202
Reno, NV 89502-0837
Phone (775) 982-4590

Other identifiers 1

IdentifierTypeStateIssuer
351651MedicaidAZ

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
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
1098CAMDSpecialist
094968AZMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1790894426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 KUENZLI ST STE 202",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895020837",
            "telephone_number": "775-982-4590",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 RYLAND ST STE 105",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021668",
            "telephone_number": "775-982-5640",
            "fax_number": "775-982-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LYNN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "CNM, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "094968",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NV",
            "license": "APRN001758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351651",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.