Active NPI
Paul R Kenney, MD
- Diagnostic Radiology Physician
- Papillion, NE
National Provider Identifier
1821010646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 17547
- Practice address
- 11111 S 84TH St
Ste 2476
Papillion, NE 68046-4122 - Phone
- (402) 339-8991
- Fax
- (402) 339-6741
- NPI assigned
- Jul 24, 2006
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 17547 | NE | Primary |
Addresses
Primary practice location
11111 S 84TH St
Ste 2476
Papillion, NE 68046-4122
Mailing address
11111 South 84TH Street
Ste 2476
Papillion, NE 68046-4122
Phone (402) 339-8991
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 |
|---|---|---|---|
| 17547 | NE | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1821010646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11111 SOUTH 84TH STREET",
"address_2": "STE 2476",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680464122",
"telephone_number": "402-339-8991",
"fax_number": "402-339-6741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11111 S 84TH ST",
"address_2": "STE 2476",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680464122",
"telephone_number": "402-339-8991",
"fax_number": "402-339-6741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEY",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NE",
"license": "17547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Papillion, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.