Mark S Kennedy, ARNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

141364 Issued in MO

Practice address

1355 Rocketdyne Rd
Neosho, MO 64850-3106

Phone

(417) 451-7425

Fax

(417) 451-7455

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1811028673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4725",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648034725",
            "telephone_number": "417-451-7425",
            "fax_number": "417-451-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 ROCKETDYNE RD",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648503106",
            "telephone_number": "417-451-7425",
            "fax_number": "417-451-7455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Park St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "MO",
            "postal_code": "648319280",
            "country_code": "US",
            "telephone_number": "417-845-0545",
            "fax_number": "417-845-0548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "66851",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45922",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "141364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Jolley, OTA
• Jon L Reagan DDS PC
• Junior College District of Newton & McDonald Co
• Megan Keel
• Danielle N Kelsey, LCSW
• Barbara E Khan, LPC
• Daud Y Khan, DO
• Joshua Kile, PTA
• Stephanie Nicole Kinsch, PTA
• Ashleigh Hope Kohley, DO

• Family Nurse Practitioner in Neosho, MO
• Providers in Neosho, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.