Rachel Shanan Kennedy

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

53773 Issued in CA

Practice address

1440 Military W Ste 101
Benicia, CA 94510-2446

Phone

(707) 745-0711

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: rkennedy25676@hpmg.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Health Center of Benicia

  • Family Medicine Physician
  • Benicia, CA
  • NPI 1336194646
  Medicare reassignment

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1801095799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 MILITARY W",
            "address_2": "STE 101",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945102446",
            "telephone_number": "707-745-0711",
            "fax_number": "707-745-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 MILITARY W STE 101",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945102446",
            "telephone_number": "707-745-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "RACHEL",
        "middle_name": "SHANAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "4090",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Kaplan, MFT
• Gail Mary Katic, RN
• Gregory James Kaufman, D.C.
• Laurel Amy Keala, MS
• Camille Reynolds Keene, RDHAP
• James W Kenshalo, LCSW
• Justin Keppel, PPS
• June Kim-Ryujin, OTR/L
• Kristina Jin Kim, D.O.
• Sun Mi Kim

• Medical Physician Assistant in Benicia, CA
• Providers in Benicia, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.